Palladian has continually grown its client base, and currently provides an array of muscular skeletal health services to nearly 20 major health plans in the United States with approximately 6 million members.  Specific services are currently provided by Palladian to its health plan clients related to management of chiropractic, physical and occupational therapy, speech pathology, massage therapy acupuncture, and fitness benefits.

Clinical Peer Reviewer – Part time and Full time

IMPORTANT NOTE: THIS IS NOT A POSTING FOR A CURRENT OPEN POSITION BUT IS FOR CONSIDERATION OF POTENTIAL FUTURE JOB OPPORTUNITIES WITH PALLADIAN HEALTH, LLC.

The Clinical Peer Reviewer is responsible for providing decisions pertaining to discipline-specific medical necessity of care.  Such medical necessity determinations are consistent with the Palladian Health Clinical Criteria, Palladian Health Policies and Procedures, state and federal regulations, as well as national accrediting agency standards. Medical necessity decisions along with classification of service type, which determines timeliness of file processing, are made in response to the submission of medical information. Classification of service type includes, but is not limited to:

• Pre-service -  urgent and non-urgent
• Concurrent  - urgent and non-urgent, and
• Post service.

The Clinical Peer Reviewer is also responsible for rendering decisions for reconsiderations and first level clinical appeals. 

Requirements include:

• Current, unrestricted NYS DC or PT license required
• Five (5) years clinical experience preferred
• Knowledge of evidence based practices
• Outpatient clinical background preferred