Remote Chart Review Physicians

Max Populi
Published
May 16, 2020
Location
Any, Any
Job Type
Work Setting
  • Remote
Rate
  • Hourly
  • Yearly
  • Per task/project
  • TBD
Qualifications
DO, MD

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Description

100% Remote opportunity to conduct utilization management - chart reviews for a brand name specialty benefits company.

 

We are seeking several physicians with a board certification in Orthopedic Surgery and Spine fellowship to support expansion needs for the musculoskeletal specialty.

- No long commutes to an office

- flexible schedules including weekend hours available

- part time or full time opportunities open

- Work from the comfort of your home office

- Impact care within a growing MSK specialty

- All State licenses welcome

- Must be proficient using Windows

- Must be willing to train "on the job"

 

Minimum Requirements:

  • The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in a specialty recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).
  • Knowledge of applicable state and federal laws, URAC and NCQA standards a plus, and familiarity with automated processes and computer applications and systems is required Responsibilities:
  • Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
  • Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
  • Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
  • Documents all actions related to clinical review sessions and attests to appeal review qualifications as required.
  • Maintains files of all reviews as required by law and Health Plans to retrieve reportable data.
  • Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.
  • Supports the annual review of utilization review criteria.
  • Supports and communicates eviCore policy and procedures to the provider community.
  • Participates in strategic planning for and evaluation of the Care Management process/unit.
  • Assists with staff educational training and in-service programs and serves as a clinical resource for eviCore staff. Our client is committed to making a positive impact on healthcare, and also making a positive impact on our employees. This role offers a variety of perks and benefits including, but not limited to:
  • Flexible scheduling and work/life balance with remote and work from home opportunities
  • 4 weeks of PTO (starting) per year plus paid holidays
  • Education assistance, tuition reimbursement and professional certifications
  • Health, dental, vision, and life benefits with employer funded HSA
  • Comprehensive employee discount program, onsite fitness facilities, and smart casual dress code
  • Paid Volunteer Community Service Days
  • Ample opportunities for growth, advancement, and promotion
  • 401k retirement plan with company match of 50% employee contributions up to 6% If interested, please send resume to skumar@maxpopuli.com or skumar@medpopuli.com.

Max Populi, LLC

4628 Bayard Street, #207

Pittsburgh, PA 15213-2750

Tel: (412) 567-5279

Fax: (412) 567-5198

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