Peer Reviewer - Orthopedic Surgery Non-Spine Physician - remote

Michigan Peer Review Organization; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A healthcare quality organization is seeking a Peer Reviewer for Orthopedic Surgery Non-Spine to conduct independent medical reviews. This remote position requires clinical expertise and a commitment to quality care. Ideal candidates should have at least five years of clinical experience, hold an unrestricted medical license, and be board certified if applicable. Flexible working hours allow for remote case review.

Benefits

Work remotely from home or office

Competitive compensation

Professional recognition in your specialty

Qualifications

• Minimum of five years of clinical experience.
• Experience in direct patient care within the last three years.
• Must be engaged in patient care for at least 20 hours per week.

Responsibilities

• Conduct peer reviews of clinical cases.
• Make determinations on medical necessity and quality of care.
• Submit reviews in a timely manner using provided IT systems.

Skills

Clinical expertise in Orthopedic Surgery

Knowledge of evidence-based guidelines

Proficient in Microsoft Word

Education

Unrestricted medical license in any U.S. state

Board Certification

Job description

Career Opportunities with iMPROve Health

A great place to work.

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Peer Reviewer - Orthopedic Surgery Non-Spine Physician - remote

iMPROve Health is an seeking an Orthopedic Surgery Non-Spine physician to join our team in conducting independent medical reviews. As a peer reviewer, you’ll play a vital role in enhancing the quality of health care by applying your clinical expertise to evaluate cases for medical necessity and quality of care.

This is a flexible, remote opportunity for clinicians who are passionate about maintaining the integrity of their specialty and supporting evidence-based practice.

BENEFITS:

• Make a Difference: Use your clinical knowledge to improve the quality of care patients receive.
• Professional Recognition: Join a network of highly respected experts in your specialty.
• Competitive Compensation: Receive fair pay for your time and expertise.
• Protect Standards of Care: Help uphold the integrity of your profession.
• Work Remotely: Review cases from the convenience of your home or office.

DUTIES AND RESPONSIBILITIES:

• Conduct objective, evidence-based peer reviews of clinical cases.
• Make final determinations regarding medical necessity and quality of care.
• Ensure decisions are fair, unbiased, and aligned with current standards of practice.
• Submit reviews in a timely and professional manner using the IT systems provided.

QUALIFICATIONS:

• Medical License: Must hold an unrestricted medical license in any U.S. state.
• Board Certification: Required (if applicable), through a board recognized by:
  • The American Board of Medical Specialties (ABMS),
  • The American Osteopathic Association (AOA), or
  • Another nationally recognized board granting certification.
• Clinical Experience:
  • Have at least five (5) years full-time equivalent experience providing direct clinical care to patients.
  • Have experience providing direct clinical care to patients within the past three (3) years.
  • Knowledgeable of the issue under review, or of the current, evidence-based clinical guidelines and novel treatments for the medical or behavioral health condition, disease, treatment, or procedure under review.
  • Have the clinical expertise to manage the medical or behavioral health condition or disease under review.
  • Must be actively engaged in direct or virtual patient care for at least 20 hours per week. Administrative work does not qualify.

TECHNOLOGY REQUIREMENTS:

• Reliable Wi-Fi access.
• Proficiency with Microsoft Word.
• Access to a computer compatible with iMPROve Health’s IT systems.

OTHER REQUIREMENTS:

• Must complete the electronic credentialing application and receive organizational approval prior to performing a case review.
• Must complete a conflict of interest attestation upon credentialing and prior to performing a case review.
• Active hospital medical staff privileges may be required, as applicable.
• Notify the organization in a timely manner of an adverse change in licensure or certification status, including board certification status.
• Cannot have current employment or affiliation with any Veterans Affairs (VA) hospital, health care system, or medical center if applying to perform VA-related peer reviews.