Physician Peer Reviewer NY Licensed Internal or Family Medicine Board Certified - New York
1 month ago

Job summary
A vital role of the CMO Administration team,the Medical Peer Reviewer plays a critical role in consulting on medical necessity in
the context of utilization management and ensuring adherence to internal Healthfirst
and external regulations.
The Medical Peer Reviewer will assess/review requests for authorization,
and claims payment, based on medical records and internal Healthfirst information
and make informed clinical judgments and recommendations.
Job description
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