Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Salary up to $173,200 annually
- Opportunity for career advancement and growth within the organization
- Work remotely anywhere within the continental U.S.
- Comprehensive benefits package including incentive and recognition programs, equity stock purchase, and 401k contribution
- Clear direction on what it takes to succeed in the role and development opportunities for other positions
- Challenging work environment that rewards and recognizes performance

What to Expect (Job Responsibilities):
- Work as part of an integrated team of medical director physicians, other physician assistants, and other members of the MCR staff
- Perform individual case review for Medical Claim Review for various health plan and insurance products
- Communicate with UHG medical directors regarding MCR decision rationales and benefit interpretations
- Actively participate in team meetings focused on communication, feedback, problem solving, process improvement, staff training and evaluation
- Provide clinical and strategic input when participating in organizational committees, projects, and task forces

What is Required (Qualifications):
- Active, unrestricted Physician Assistant license
- Board-certified by NCCPA
- 8+ years of post-graduate, hands-on clinical experience
- 2+ years of experience in hospital-based medicine
- Intermediate or higher level of proficiency with managed care

How to Stand Out (Preferred Qualifications):
- 10+ years of experience in post-graduate, hands-on clinical practice
- 2+ years of experience in Quality Management
- Experience with claims coding & review
- Experience with managed care principles & utilization of evidence-based clinical criteria
- Familiarity with current medical issues and practices

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