Radiation Oncologists - Physician Advisor

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Glendale, CA
$218,600 - $218,600
Job Type
Direct Hire
Medical Doctor
Sep 05, 2017
Job ID
With over 32 million members covered across 50 states, our client ensures delivery of the right test at the right time in the right place.

Location:  Glendale, CA

Seeking a Board-Certified Radiation Oncologist to participate in pre-authorization and quality improvement solutions for for radiation therapy and related radiology requests.   Physician Reviewers determine the medical necessity of outpatient requests using clinical appropriateness guidelines and health plan medical policy.  Will also consider part time hours between 8-5 (M-F).

 Responsibilities include:
  • Perform physician-level case review of radiation therapy procedures and related radiology studies
  • Determine medical necessity of requests using Clinical Appropriateness  Guidelines and client-specific health plan medical policy
  • Conduct peer-to-peer consultations with ordering physicians, physician assistants, and advanced practice nurses to provide education regarding established guidelines and accepted standards of care radiation treatments, related radiology studies and sites of care
  • Suggest alternative treatments, studies and/or sites of care  to ordering providers when appropriate
  • Provide support and educate clinical and non-clinical staff to foster understanding of the principles associated with appropriate use of radiation therapy procedures and related radiology studies
  • Actively participate in physician team meetings.
  • Demonstrate and maintain knowledge of relevant policies and regulations pertaining to radiation therapy and related radiology studies
  • Actively participate in groups that develop, revise and enhance  clinical appropriateness guidelines
  • Perform first level provider appeals of coverage decisions.
  • Obtain additional state licensure based upon state regulations and health plan needs
Current unrestricted medical license(s) to practice medicine in California   and a Board Certification in Radiation Oncology by American Board of Internal Medicine.
Demonstrated knowledge of current practice standards in specialty
Strong oral communication and interpersonal skills
Computer literacy with Microsoft Office and Lync, and the ability to learn new applications
Strong analytical skills