Vascular Neurologist

We are looking for a 100% Remote, 1099,Vascular Neurology MD/DOReviewerDescription: · 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 RequestedLayman 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.S ystems and Tools:· Expert Reviewers must use their own personal computer to access a web-based portalT raining:· Review Training –Trainer will work closely with reviewer for the first 3-5 cases · Scheduled Training- based on reviewer’s schedule · D eliverables:· No direct defined evidence standard or guidelines · Templates will be used to complete reviewsProvider Specialty Vascular NeurologyM inimum Qualifications: • Active license •24 hours of direct patient care per week •5 years’ experience in appropriate specialty post training •Board CertificationRates per caseM edical Necessity Review: Standard Case Most common type of review 30 – 45 minutes to complete 5 – 7 days to turnaround $150.00 per reviewM edical Necessity Review: Expedited Case Sickest patients 24-hour turnaround 45 min - 1 hour to complete $250.00 per reviewE xperimental/Investigational Reviews: Standard Case Second most common review 1-2 hours to complete (based on experience) 5 - 7-day turnaround $300.00 per review Volume: Varies based on needE xperimental/Investigational Reviews: Expedited Case Sickest of patients 24-hour turnaround 1-2 hours to complete (based on experience) $400.00 per reviewFor more information about Maximus, please visit https://maximus.com/ to learn more about our organization.