Physician Peer Reviewer (MT, ID, WA, OR)
Company: VirtualVocations
Location: Sioux Falls
Posted on: March 26, 2025
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Job Description:
A company is looking for a Physician Peer Reviewer.
Key Responsibilities
Interface with various departments including Care Management and
Clinical teams
Review and manage appeals, and provide expertise in claims
adjudication and care management issues
Conduct utilization review activities and assist with provider
credentialing and Pharmacy and Therapeutics Committee functions
Required Qualifications
Doctor of Medicine (MD or DO) with an unrestricted license in MT,
ID, WA, or OR
Minimum of three years of experience as an Assistant Medical
Director or Medical Officer in a health insurance plan
Board certification recognized by the American Board of Medical
Specialties (ABMS) is preferred
Comprehensive knowledge of healthcare business principles and
quality improvement methodologies
Basic computer skills and the ability to read and comprehend
Spanish is a plus
Keywords: VirtualVocations, Sioux Falls , Physician Peer Reviewer (MT, ID, WA, OR), Healthcare , Sioux Falls, South Dakota
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