Thursday, August 23, 2018

Job Posting: Physician Clinical Reviewer

Magellan Health is actively hiring for Physician Clinical Reviewers

Physician Clinical Reviewer

• Key member of utilization management team, and provides timely medical review of service requests that
do not initially meet the applicable medical necessity guidelines.
• Reviews all specialty cases in which clinical determinations cannot be made by the initial clinical reviewer.
• Discusses determinations with requesting physicians or ordering providers, when available, within the
regulatory timeframe of the request by phone.
• Provides clinical rationale for standard and expedited appeals.

Magellan Health offers a complete range of full service health care, including behavioral health, pharmacy benefits management and specialty health care solutions. Magellan Health includes divisions such as Magellan Healthcare and Magellan Rx Management.

Learn more about this role and apply here

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