Physician Reviewer, Neurological Surgery - NV

Dane Street, LLC; Reno (NV); On-site; USD 60,000 - 90,000; Part time

Benefits offered by this job

Schedule flexibility

Supplemental income opportunity

Enhanced industry expertise

Job summary

A healthcare consulting firm is seeking a Physician Reviewer/Advisor to provide clinical expertise in reviewing medical records and ensuring compliance with treatment guidelines. This telework position offers flexible scheduling and supplemental income opportunities. Candidates must hold a Nevada Medical License and have a strong background in medical necessity and utilization review.

Qualifications

• Must hold a Nevada Medical License.
• Experience in utilization review is preferred.
• Ability to analyze complex medical information.

Responsibilities

• Review medical records and address client-specific questions.
• Provide clear rationale and supporting documentation for decisions.
• Ensure adherence to guidelines and standards of care.
• Maintain proper credentialing and licenses.
• Attend orientation and training and address quality assurance issues.

Skills

Clinical expertise

Medical necessity determination

Familiarity with clinical treatment guidelines

Ability to provide concise rationale

Analytical skills

Education

Nevada Medical License (M.D., D.O.)

Job description

This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis.

Preferred candidates will hold Nevada Medical License (M.D., D.O.)

JOB SUMMARY

Physician Reviewer/Advisor utilizes clinical expertise to review, provide interpretation of clinical treatment guidelines and opine on the medical necessity of services/treatment proposed or provided by other healthcare professionals in compliance with client-specific policies, nationally recognized evidence-based guidelines, and standards of care.

MAJOR DUTIES AND RESPONSIBILITIES:

• Reviews all medical records and addresses each question posed utilizing client-specific criteria or other nationally recognized evidence-based criteria
• Ensures a clear rationale for determination that is concise and contains adequate supporting documentation to substantiate the decision
• Identifies and employs current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes
• Provides a report and copies of any criteria utilized within the review promptly
• Returns cases on or before the due date and time specified
• Completes calls/call attempts as mandated by the state and/or client specifics
• Maintains proper credentialing, required licenses, and any special certifications and adheres to requirements necessary to perform in the role of Physician Reviewer/Advisor
• Attends required orientation and training
• Performs other duties as assigned including identifying and responding to potential quality assurance issues, complaints, and regulatory issues.

PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment.

• Robust opportunity for supplemental income
• Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability
• No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
• Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise
• Expanded credentials as an expert in Independent Medical Exams and physician advisor services
• Streamlined case flow and user-friendly work portal

Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.