Pediatrician

Maximus; Falls Church (VA); Remote; Vollzeit

Zusammenfassung

Maximus is seeking a 100% remote Pediatrics Clinical Genetics physician to serve as a Medical Expert Reviewer for the California DMHC. MD/DO with board certification is required.

You will review denied treatment requests and render final medical determinations based on Medical Necessity and Emergency criteria. Reviews are specialty-driven, completed through a secure web portal, and do not involve direct patient care.

Qualifikationen

• Board certified in Pediatrics with more than 5 years of experience.
• Experience with Clinical Genetics for at least 5 years.
• MD/DO license required.

Aufgaben

• Review denial of treatment requests and render final medical determinations based on Medical Necessity and Emergency criteria.
• Reviews are specialty-driven, completed through a secure web-based portal, and do not involve direct patient care.

Kenntnisse

Pediatrics

Clinical Genetics

Medical evaluation

Ausbildung

MD/DO degree

Jobbeschreibung

Pediatrics - Clinical Genetics - MD/DO Reviewer (Remote | 1099)

We are seeking a100% remote, Pediatric Clinical Genetics Physician MD/DO to serve as a Medical Expert Reviewer for the California Department of Managed Health Care (DMHC).

Role Summary Review denied treatment requests and render final medical determinations based on

• Medical Necessity
• Emergency

Reviews are specialty-driven, completed through a secure web-based portal, and do not involve direct patient care.

Requirement

• Board Certified in Pediatrics for more than 5 years
• Experience with Clinical Genetics for at least 5 years
• 24 hours/week of in person patient care.
• MD/DO

Compensation (Per Case)

• $150/cs Standard Medical Necessity
• $250/cs Expedited Medical Necessity (Due in less than 24 hrs. as per directions)
• $400/cs Expedited Experimental/Investigational (Due in less than 24 hrs. as per directions