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Associate Medical Director- Board Certified Orthopedic Surgeon- REMOTE MF
Vienna, Virginia, United States
Job Summary
Occupation
Physician
Specialty
Orthopedics
Degree Required
MD/DO
Position Type
Permanent/Full-Time
Locums/Travel
Part-Time/Contract
Work Environment
Ambulatory Surgery Center (ASC)
Academic/Training Program
Hospital
Clinic/Private Practice
Location
Hawaii, United States
Visa Sponsorship
No
Job Description
Last Update:
4/29/18
This is a Remote Position
We are considering those interested in working full time or part time. Full time hours are a daily set schedule from 8a-5p.
Full time is 40 hours a week and includes a full comprehensive benefits package
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Review appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
Provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
Documents all actions related to clinical review sessions and attests to appeal review qualifications as required.
Maintains files of all reviews as required by law and Health Plans to retrieve reportable data
To be considered you should have an active unrestricted license to practice medicine in a state or territory of the United States as a utilization review doctor of medicine or doctor of osteopathic medicine and knowledge of applicable state and federal laws, URAC and NCQA standards. Familiarity with automated processes and computer applications and systems also required. Must have a minimum of five (5) years of clinical practice experience.
You must be board certified through the ABMS.
We are considering those interested in working full time or part time. Full time hours are a daily set schedule from 8a-5p.
Full time is 40 hours a week and includes a full comprehensive benefits package
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Review appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
Provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
Documents all actions related to clinical review sessions and attests to appeal review qualifications as required.
Maintains files of all reviews as required by law and Health Plans to retrieve reportable data
To be considered you should have an active unrestricted license to practice medicine in a state or territory of the United States as a utilization review doctor of medicine or doctor of osteopathic medicine and knowledge of applicable state and federal laws, URAC and NCQA standards. Familiarity with automated processes and computer applications and systems also required. Must have a minimum of five (5) years of clinical practice experience.
You must be board certified through the ABMS.