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Maximus Federal & VES
Thoracic and Cardiac Surgery MD/DOMaximus Federal & VES • CA, US
Thoracic and Cardiac Surgery MD/DO

Thoracic and Cardiac Surgery MD/DO

Maximus Federal & VES • CA, US
30+ days ago
Job type
  • Permanent
Job description

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
Keithstewart@maximus.com

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Thoracic and Cardiac Surgery MD/DO • CA, US

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