Pediatrician

3 weeks ago Be among the first 25 applicantsGet AI-powered advice on this job and more exclusive features.Direct message the job poster from MaximusWe are looking for a 100% Remote, 1099, Pediatric Infectious Disease MD/DO ReviewerDescription:· 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 RequestedThis 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 portalReview Training –Trainer will work closely with reviewer for the first 3-5 cases ·Scheduled Training- based on reviewer’s scheduleNo direct defined evidence standard or guidelines·Templates will be used to complete reviewsProvider SpecialtyPediatric Infectious DiseaseMinimum Qualifications:•24 hours of direct patient care per week•5 years’ experience in appropriate specialty post trainingMedical Necessity Review: Standard CaseMost common type of review30 – 45 minutes to complete5 – 7 days to turnaroundMedical Necessity Review: Expedited CaseSickest patients 24-hour turnaround45 min - 1 hour to completeExperimental/Investigational Reviews: Standard CaseSecond most common review1-2 hours to complete (based on experience)5 - 7-day turnaroundVolume: Varies based on needExperimental/Investigational Reviews: Expedited CaseSickest of patients 24-hour turnaround1-2 hours to complete (based on experience)For more information about Maximus, please visit https://maximus.com/ to learn more about our organization.Keith StewartClinical RecruiterSeniority levelSeniority levelNot ApplicableEmployment typeEmployment typeContractJob functionJob functionHealth Care Provider and ConsultingIndustriesHospitals and Health Care and Government AdministrationReferrals increase your chances of interviewing at Maximus by 2xSign in to set job alerts for “Pediatrician” roles.Pediatrics - Infectious Disease Physician Job with UPMC in Pittsburgh, PAPediatrician Advisor at Healthcare Venture Capital Fund - Healthcare SharesFresno, CA $320,000.00-$380,000.00 3 months agoNeonatologist Advisor at Healthcare Venture Capital Fund - Healthcare SharesChild & Adolescent Psychiatry Utilization Review - (Remote - 1099) TXLamont, CA $265,000.00-$290,000.00 1 month agoNaturopathic Doctor (Part-Time/Contract) - Future OpeningsMedical Affair- ophthalmology required （contractor）California, United States $120.00-$130.00 6 days agoGreenville, SC $300,000.00-$400,000.00 2 days agoHospitalist Advisor to Healthcare Venture Capital FirmOphthalmology - Remote 1099 Utilization Review WorkLocum Tenens Physician - Make $380/hr - $400/hrColumbia, SC $300,000.00-$400,000.00 2 days agoGreenville, SC $300,000.00-$400,000.00 1 day agoFlorence, SC $300,000.00-$400,000.00 1 day agoOregon, United States $155.00-$165.00 3 months agoPhysician - Virtual Urgent Care (Part-time)Clinical Research Physician - DevelopmentIndiana, United States $198,000.00-$336,600.00 1 day agoWe’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #J-18808-Ljbffr