Sleep Medicine Medical Reviewer - Marietta Georgia

Company: VirtualVocations
Location: Marietta, Georgia
Posted On: 01/22/2025

A company is looking for a Sleep Medicine - Utilization Management Medical Reviewer (Part Time).



Key Responsibilities

Conduct medical necessity reviews and issue adverse determinations as needed
Achieve Service Level Agreement (SLA) metrics and performance guarantees for health plan clients
Work up to 20 hours a week, including weekends and holidays


Required Qualifications, Training, and Education

MD or DO with an active and unencumbered medical license
Current and unexpired specialty board certifications in internal medicine with certification in sleep medicine, pulmonology, or as a somnologist
3-5 years of experience in clinical practice
3-5 years of experience in utilization review
Prior experience utilizing evidence-based clinical guidelines (e.g., Milliman/Interqual) is preferred More...

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