Physician - Surgery

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 enrollees 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 reviewers 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

[email protected]