Pediatric Neurologist

We are looking for a 100% Remote, 1099, Pediatric NeurologistMD/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 Pediatric NeurologistM 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. Seniority Level Not Applicable Industry Hospitals and Health Care Government Administration Employment Type Contract Job Functions Health Care Provider Consulting Skills Training Hematology Oncology Internal Medicine Evidence Templates Cancer Medical Review Research Skills Stem