The physician reviews completed genetic counseling cases asynchronously to determine medical necessity for genetic testing and related care. This role focuses on diagnostic-driven, remote review rather than direct in-person patient visits, with work supporting claims for federal payers. The practice uses a multidisciplinary model that combines physicians, genetic counselors, technology, and care coordination support.
Key Responsibilities
- Conduct asynchronous medical necessity reviews after genetic counseling sessions.
- Review documentation and clinical criteria to determine appropriateness of genetic testing.
- Ensure decisions align with applicable state and federal regulations.
- Document medical necessity findings accurately and thoroughly.
- Collaborate with genetic counselors, physicians, and support staff in a remote care workflow.
- Support compliant, diagnostic-driven care for payer-submitted claims.
Required
- Physician degree (MD or DO).
- Ability to perform medical necessity reviews for genetic testing.
- Strong understanding of documentation standards and applicable state and federal regulations.
Preferred
- Experience with genetic testing or genetics-related clinical workflows.
- Experience in telehealth or asynchronous review models.
- Familiarity with payer-facing documentation and utilization review processes.
Benefits & Perks
- Remote, telehealth-based work model.
- Access to a physician, registered nurse, and genetic counselor network.
- Strong care coordination and patient support infrastructure.
- Technology-enabled workflow supporting diagnostic review and patient care.