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