Peer to Peer Physician

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🕒 June 22

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Ellit Groups

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2019

💼 Consulting

📣 Marketing

📦 Logistics

Consulting • Marketing • Logistics

Ellit Groups is a forward-thinking organization dedicated to transforming healthcare through innovative solutions. They specialize in bridging the gap between people, processes, and technology, effectively addressing business challenges within the healthcare and life sciences sectors. With an award-winning team of experts, Ellit Groups offers services such as healthcare and payer advisory, performance improvement, digital strategy and transformation, and managed services. Their commitment to enhancing patient outcomes and fostering sustainable growth makes them a vital partner for healthcare organizations and life sciences companies.

📋 Description

• Participate in peer-to-peer calls with treating providers to review clinical decisions and treatment plans. • Help clarify medical necessity decisions using evidence-based guidelines and standard clinical criteria. • Review patient documentation from ambulatory and long-term care settings to support those discussions. • Provide clear, practical clinical reasoning that helps move cases toward resolution. • Work within Lumens and other ambulatory systems to support workflow and documentation needs. • Collaborate with utilization management and care coordination teams on escalated or time-sensitive cases. • Support consistent, fair, and clinically appropriate decision-making across cases.

🎯 Requirements

• MD or DO with an active, unrestricted U.S. medical license. • Board-certified physician. • Strong clinical background with experience applying guidelines in real-world decision-making. • Prior exposure to utilization management, prior auth, or peer-to-peer discussions is strongly preferred. • Comfortable working across outpatient and long-term care clinical environments.

🏖️ Benefits

• Competitive salary and benefits package. • Opportunity to work in a collaborative and innovative environment. • Professional development opportunities to advance your career. • Flexible work arrangements to promote work-life balance.