Job Description

Job Overview Remote position; must have Texas Medical Licensure. Responsibilities Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests. Provide clinical leadership in other areas of the organization. Identify opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member. Participate in the process to evaluate clinical service requests. Practice anticipatory case management for members whose cases come for review, in partnership with case managers. Participate in the development of Physician Review Units' policies and procedures. Actively participate in all unit continuous quality improvement activities. Other duties as assigned by the Medical Director. Qualifications Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine requested. 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background. Understanding of managed care. Demonstrate PC proficiency, as file review will be done via computer in most cases. Position does not provide direct patient care or medical diagnosis. EEO Statement "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans." #J-18808-Ljbffr Mindlance

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