Remote Pediatrician — Medical Review & Policy Expert

Gainwell Technologies LLC

Sacramento (CA)

Hybrid

USD 122,000 - 174,000

Part time

10 days ago

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Job summary

Gainwell Technologies LLC is seeking a pediatrician for a part-time, contract role within the Medi-Cal MMIS account for the California Department of Health Care Services. The position focuses on online reviews of medical documentation requiring pediatric expertise and entails remote work with periodic travel to West Sacramento.

Ideal candidates have 3+ years of pediatric clinical experience, CA medical licensure, and strong communication and analytical skills.

Qualifications

Minimum of three (3) years of clinical experience as a pediatrician.
A current California medical license.
Strong communication skills, as well as strong interpersonal and analytical skills.
Must reside within 35 miles of the Sacramento State Capitol, California.
Comfortable using Word, Excel, and Outlook.

Responsibilities

Respond to medical referrals from DHCS within four (4) hours of notification.
Review policy and attend meetings with DHCS.
Process suspended claims requiring expertise from a medical specialist and respond to referrals from internal departments.
Hybrid work environment. This is primarily a remote position. Occasionally, travel to the MOC in West Sacramento may be required.
Cross-train to help provide coverage for other consultants when required.