Thoracic and Cardiac Surgery MD/DO

We are looking for a 100% Remote, 1099, Supplemental Income, Thoracic and Cardiac Surgery 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
Thoracic and Cardiac Surgery

Minimum Qualifications:

• Active license
• 24 hours of direct patient care per week
• 5 years’ experience in appropriate specialty post training
• Board Certification

Rates per case
$150.00 per review to $400.00 per review per case

For more information about Maximus, please visit https://maximus.com/ to learn more about our organization.

Keith Stewart 
Clinical Recruiter
Keithstewart@maximus.com