100% fully remote, 1099, supplemental income, remote Internal Medicine, MD/DO role.

About the Company

100% fully remote, 1099, supplemental income, remote Internal Medicine, MD/DO role.

California Dept of Managed Health Care Independent Medical Review CA DMHC-IMR Project.

About the Role

These reviews will be strictly related to Internal Medicine specialty.

Responsibilities

• Medical Expert Reviewer-Medical Expert Judgement Reviews determining final decision based off enrollee’s denial of treatment-coverage denied by the DMHC.
• Reviews are based off Medical Necessity and Experimental/Investigational.
• Specialty Driven-Expert within the Specialty Requested.
• 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 DMHC (Department of Managed Health Care) or not.
• The reviewers who conduct these medical judgment reviews are experts in the specific field of medicine related to the treatment being considered.
• Provider can accept or decline cases; must do so within 24 hrs.
• Once accepted the review must be submitted within 3-5 business days, expedited cases are within 24 hours.

Qualifications

• Active license **Any state license can be used for this role**
• 24 hours of direct patient care per week currently
• 5 years’ experience post fellowship
• Board Certification
• Decline any reviews without penalty (24 hrs.)
• No history of disciplinary actions against license

There is also training provided for the systems use.

You will be under Maximus’s coverage so within these reviews you are not liable for anything because you are not diagnosing, seeing any patients, you are merely reviewing a file and providing your medical expert opinion.

Pay range and compensation package

The rates per case: Will discuss over a call.

Please send me your most updated CV

Breannagonzalez@maximus.com

As a leading strategic partner to governments across the globe, Maximus helps improve the delivery of public services amid complex technology, health, economic, environmental, and social challenges. With a deep understanding of program service delivery, acute insights that achieve operational excellence, and an extensive awareness of the needs of the people being served, our employees advance the critical missions of our partners. Maximus delivers innovative business process management, impactful consulting services, and technology solutions that provide improved outcomes for the public and higher levels of productivity and efficiency of government-sponsored programs. For more information, visit maximus.com.