REMOTE Medical Review Officer (MRO) needed - Cerritos CA – 3 – 6 months Full Time M-F
Dallas, Texas, United States
Job Summary
Occupation
Physician
Specialty
Administrative/CEO
Degree Required
MD/DO
Position Type
Permanent/Full-Time
Work Environment
Corporate/Non-Clinical
Location
Cerritos, California, United States
Visa Sponsorship
No
Job Description
Last Update:
2/26/24
- Remote role responsible for the administration of medical services, to ensure the appropriate and most cost effective medical care is received.
- May provide clinical consultation and serve as clinical/strategic advisor to enhance clinical operations and a resource to clinical staff
- Supports clinicians to ensure timely and consistent responses to members and providers.
- May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss review determinations
- Interprets medical policies and clinical guidelines.
- Requires MD or DO and current Board certification
- Must possess an active unrestricted medical license to practice medicine in CA
- Standard hours are 8 AM – 5 PM PT M-F
- Available to work weekends and holiday’s on a rotation assignment for call coverage
- Ensures timely review of all case work to meet business turnaround times
- Reports to Managing Medical Director and works with a staff of 3 other MD reviewers
Interested?
Robert Hewitt, MSc.
Maxim Healthcare