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Clemson University

Clemson, South Carolina

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University of Wisconsin-La Crosse

La Crosse, Wisconsin

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Northeast Georgia Health System

Gainesville, Georgia

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St. Luke's Health System

Boise, Idaho

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Baylor Scott & White Health

Temple, Texas

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Phoenix Children's

Phoenix, Arizona

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Raleigh, North Carolina

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University of Maryland Medical System

Baltimore, Maryland

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Northeast Georgia Health System

Blairsville, Georgia

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Akron Children's

Boardman, Ohio

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Duke University Health System

Durham, North Carolina

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Akron Children's

Millersburg, Ohio

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Northeast Georgia Health System

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Northeast Georgia Health System

Gainesville, Georgia

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LifeStance Health

Warwick, RI

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Northeast Georgia Health System

Gainesville, Georgia

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Akron Children's

Akron, Ohio

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Duke University Health System

Oxford, North Carolina

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Vanderbilt Health

Nashville, Tennessee

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LifeStance Health

Bloomington, MN

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Physician Reviewer
DescriptionScope: Serves as an expert physician resource and reviewer.REPRESENTATIVE RESPONSIBILITIES???Medical ReviewPerforms medical review activities pertaining to delegated pediatric services including medical review of complex, controversial, or experimental medical services???QualityAssists Medical Director in improving quality and cost-effectiveness of care and service for members and provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, institutional, and accreditation requirements???UtilizationIdentifies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of be


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