Physician Peer Reviewer – actively practicing

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🕒 July 7

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LivantaLLC

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2004

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

Livanta LLC is a technology-enabled organization dedicated to advancing healthcare quality through innovation. It specializes in providing services to patients, caregivers, healthcare providers, and payers, focusing on improving health outcomes, navigating healthcare systems, and ensuring payment accuracy. Livanta is recognized as the largest Medicare Quality Improvement Organization and offers a range of services including quality oversight, auditing, advocacy, and data analytics to enhance patient care and safety while managing healthcare costs effectively.

📋 Description

• Conduct independent, remote case reviews evaluating medical necessity, appropriateness, or quality of care. • Provide evidence-based assessments and written determinations following established clinical guidelines and review criteria. • Support case types including Utilization review, Appeals and hearings, Quality of care and standard of care concerns. • Uphold the highest standard of clinical integrity, neutrality, and objectivity.

🎯 Requirements

• Hold an active, unrestricted U.S. license as an MD/DO • Board certified in specialty by an ABMS or AOA-recognized board • Minimum of 5 years of clinical experience in specialty • Currently practicing and seeing patients an average of at least 20 hours per week • Experience with QIO, peer review, utilization review, or appeals work (preferred) • Familiarity with military or federal healthcare programs (e.g., TRICARE, Medicare) (preferred) • Previous experience with legal or regulatory case reviews (preferred)

🏖️ Benefits

• Fully remote • Flexible workload – cases assigned based on availability and specialty • Impactful work that contributes to high-quality care and oversight