Company Overview
w3r Consulting is an award-winning IT consulting and management firm, delivering innovative enterprise solutions across healthcare, financial services, and professional business sectors. As a minority-owned company, w3r leverages diverse talent and fresh perspectives to help clients gain a strategic edge in competitive global markets.
Position Overview:
As a Physician Reviewer, you’ll assess clinical service requests from members and providers, applying clinical expertise and organizational guidelines. You’ll support anticipatory case management, participate in appeals, and contribute to policy and quality improvement initiatives.
⚠️ Note: This role does not involve direct patient care or diagnosis.
Key Responsibilities:
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Review and adjudicate clinical service requests using medical judgment and internal criteria
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Collaborate with case managers on proactive care planning
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Participate in appeals and help refine review policies and procedures
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Support quality improvement initiatives within the unit
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Perform other duties as directed by the Medical Director
Qualifications:
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Board Certified M.D. or D.O. (ABMS), with an active, unrestricted license
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Minimum 5 years clinical experience, including inpatient care
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Strong understanding of managed care and proficiency with computer-based file review
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Experience in Behavioral Health or Healthcare Management preferred
Key Skills:
Case Management | File Review | Managed Care | Problem Solving | Quality Improvement