This physician role focuses on asynchronous medical necessity review after completed genetic counseling sessions, supporting diagnostic-driven care for patients using genetic testing services. The work is virtual and multi-state, with a strong emphasis on documentation quality, compliance, and aligning care decisions with payer requirements. Physicians collaborate with genetic counselors, care coordination, and technology-enabled workflows within a remote-based practice model.
Key Responsibilities
- Conduct asynchronous medical necessity reviews for completed genetic counseling cases.
- Assess whether genetic testing requests meet clinical and payer-specific medical necessity criteria.
- Provide documentation that supports claims submitted to federal payers.
- Collaborate with genetic counselors, physicians, and care support teams in a virtual care workflow.
- Use technology-enabled systems to support diagnostic review and care coordination.
- Adhere to state and federal regulations governing genetic testing and related services.
Required
- Physician degree (MD or DO).
- Multi-state medical licensure.
- Medicaid/Medicare enrollment.
- Experience or comfort with medical necessity review and documentation-based decision-making.
- Ability to work in a virtual, asynchronous care model.
Preferred
- Experience with genetic testing, genetic counseling, or genomics-related care.
- Familiarity with claims-based or payer-facing review processes.
- Experience working in remote or telehealth clinical settings.