- Evolent Health (Columbia, SC)
- …Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology , Physician Clinical Reviewer you will be a key member ... Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not...within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- Prime Therapeutics (Columbia, SC)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Physician Clinical Reviewer - Cardiology - REMOTE **Job Description ... necessity guidelines. Routinely interacts with physicians, leadership and management staff, other Physician Clinical Reviewers (PCR), and health plan members and… more
- Humana (Columbia, SC)
- …specificity and appropriateness of procedure codes based on services rendered + Review medical documentation for clinical indicators to ensure specific ... guidelines and provide reports as needed + Maintain strict patient and physician confidentiality and follow all federal, state and hospital guidelines for release… more