Gynecologist
United States
Contract
Remote
2 months ago
About the role
We are looking for a 100% Remote, 1099, Supplemental Income Gynecologic Oncology OBGYN MD/DO Reviewer
Description:
· Medical Expert Reviewer-Medical Expert Judgement Reviews determining final decision based off enrollee’s denial of treatment-coverage denied by the CA DMHC.
· Reviews-are based off Medical Necessity and Experimental/Investigational
· Specialty Driven-Expert within the Specialty Requested
Layman Terms:
This service involves getting a thorough and professional medical review from an expert provider. The review is done to make a final decision on whether a particular treatment should be covered by the CA DMHC (Department of Managed Health Care) or not. The reviews are based on two main factors: medical necessity (whether the treatment is necessary for the patient's health) and whether the treatment is experimental or investigational.
Systems and Tools: ·
Expert Reviewers must use their own personal computer to access a web-based portal
Training: ·
Review Training –Trainer will work closely with reviewer for the first 3-5 cases ·
Scheduled Training- based on reviewer’s schedule
Deliverables: ·
No direct defined evidence standard or guidelines·
Templates will be used to complete reviews
Provider Specialty
Gynecologic Oncology
Minimum Qualifications:
• Active license
•24 hours of direct patient care per week currently
•5 years’ experience in appropriate specialty post training
•Board Certification
Rates per case
$150-$400 (From 30 minutes to 1+ to complete)
For more information about Maximus, please visit https://maximus.com/ to learn more about our organization.
Description:
· Medical Expert Reviewer-Medical Expert Judgement Reviews determining final decision based off enrollee’s denial of treatment-coverage denied by the CA DMHC.
· Reviews-are based off Medical Necessity and Experimental/Investigational
· Specialty Driven-Expert within the Specialty Requested
Layman Terms:
This service involves getting a thorough and professional medical review from an expert provider. The review is done to make a final decision on whether a particular treatment should be covered by the CA DMHC (Department of Managed Health Care) or not. The reviews are based on two main factors: medical necessity (whether the treatment is necessary for the patient's health) and whether the treatment is experimental or investigational.
Systems and Tools: ·
Expert Reviewers must use their own personal computer to access a web-based portal
Training: ·
Review Training –Trainer will work closely with reviewer for the first 3-5 cases ·
Scheduled Training- based on reviewer’s schedule
Deliverables: ·
No direct defined evidence standard or guidelines·
Templates will be used to complete reviews
Provider Specialty
Gynecologic Oncology
Minimum Qualifications:
• Active license
•24 hours of direct patient care per week currently
•5 years’ experience in appropriate specialty post training
•Board Certification
Rates per case
$150-$400 (From 30 minutes to 1+ to complete)
For more information about Maximus, please visit https://maximus.com/ to learn more about our organization.