Clinical Peer Reviewer at Advantage Health Centers Detroit, MI

Clinical Peer Reviewer job at Advantage Health Centers. Detroit, MI. Summary Description Reviews patient information to ensure treatment/service provided falls within the plan guidelines and that the service was appropriate for the condition. Reviewing for positions – Physicians – (OB/GYN, Internal Medicine, Family Medicine), Physician Assistant, Nurse Practitioner Specific Responsibilities include, but are not limited to: Reviewing x-rays, patient charts and other patient records to ensure treatment/service provided is within guidelines of the plan. Review pre-authorization paperwork to ensure the intended treatment meets the treatment plan criteria and relevant program criteria. Complete Peer Review Form for each chart reviewed The list of responsibilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary, if needed. Academic and Experience Requirements Graduation from an accredited school Valid, unexpired license to practice in Michigan (Physicians) Valid, unexpired certification to practice in Michigan (Physician Assistant, Nurse Practitioner) Successful completion /passing of background check, drug screen and credential check Other Qualifications Desired: Ability to communicate effectively (verbal and written). Excellent organization and interpersonal skills required. Skilled in working with others in a team environment. Must be proficient in MS Office applications (Word, Excel, PowerPoint) Experience working with EMR systems- eCW preferred. Will train. Experience Minimum 3-5 years of experience as a Physician, Physician Assistant or Nurse Practitioner Knowledge of medical/clinical procedures, terminology, and codes. #J-18808-Ljbffr Advantage Health Centers