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Your Future Evolves Here:
Radiologists will be a key member of the utilization management team, providing a meaningful way to make a difference in patients' lives, in a non-clinical environment.
Responsibilities:
- Serve as the Physician match reviewer in Imaging cases that do not initially meet the applicable medical necessity guidelines.
- Discuss determinations (peer-to-peer phone calls) with requesting physicians or ordering providers, within the regulatory timeframe of the request and provide clinical rationale for standard and expedited appeals.
- Utilize medical/clinical review guidelines and parameters to assure consistency in the MD review process.
- Aid and act as a resource to Initial Clinical Reviewers.
