Gynecologist

Maximus; United States; Remote; USD 207,000 - 551,000; Full time

Job summary

Maximus is seeking a Gynecologic Oncology MD/DO Reviewer for a 100% remote, 1099 supplemental income role. You will perform Medical Expert Judgement reviews to determine final treatment-coverage decisions for enrollee denials, based on medical necessity and whether the treatment is experimental or investigational.

Minimum qualifications include 5 years of specialty experience post training and 24 hours of direct patient care per week.

Qualifications

• 5 years of specialty post-training experience
• 24 hours of direct patient care per week
• MD/DO with Gynecologic Oncology expertise

Responsibilities

• Medical Expert Reviewer determining final decision on enrollee denial of treatment-coverage
• Assess medical necessity and status of experimental/investigational treatments
• Provide specialty-driven reviews within the Gynecologic Oncology domain

Skills

Direct patient care

Medical review

Education

MD/DO

Board-certified Gynecologic Oncology

Job description

We are looking for a 100% Remote, 1099, Supplemental Income Gynecologic Oncology OBGYN MD/DO Reviewer

Description:

• 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 Requested

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

Review Training –Trainer will work closely with reviewer for the first 3-5 cases

Scheduled Training- based on reviewer’s schedule

No direct defined evidence standard or guidelines

Templates will be used to complete reviews

Provider Specialty

Gynecologic Oncology

Minimum Qualifications:

24 hours of direct patient care per week currently

5 years’ experience in appropriate specialty post training

$150-$400 (From 30 minutes to 1+ to complete)

For more information about Maximus, please visit https://maximus.com/ to learn more about our organization.