Physician Reviewer Remote Networking- Physician Recruitment

Dane Street, LLC • Contract • Remote • 21h ago

Dane Street, a certified "Great Place to Work" company, is in search of a Board Certified Orthopaedic Spine Surgeon, Neurosurgeon, Neurologist, and Physical Medicine & Rehabilitation physician to process utilization reviews. Worker's Compensation experience is preferred but, not required. This telework opportunity provides the ability to customize your schedule and caseload within a standard Monday - Friday work week while maintaining client-mandated turnaround times. Our reviewers are compensated on a per-case basis as a 1099 independent contractor. Preferred candidates will hold a CA, GA, FL, IL, KY, LA, NV, or TX license.

JOB SUMMARY:

Utilizes clinical expertise, and reviews workers' compensation claims by providing an interpretation of the medical appropriateness of services provided by other healthcare professionals in compliance with state regulations and guidelines, nationally recognized evidence-based guidelines, client-specifics, policies, procedures, performance standards, and URAC guidelines.

MAJOR DUTIES AND RESPONSIBILITIES:

Reviews all medical records and addresses each question posed by the client utilizing state-mandated or other nationally recognized evidence-based criteria
Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision
Returns cases on or before the due date and time
Makes telephone calls as mandated by the state and/or client specifics
Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job
Attends all required orientation and training
Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits
Identifies, critiques, and utilizes 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 copies of any criteria utilized in a review with the report in a timely manner

PLEASE BE AWARE: In the interest of the security of both parties, please be aware that Dane Street will never conduct an interview via text or request checks from candidates for purchasing equipment.

Related Jobs

Remote Physician Reviewer

Insight Global • Full-time • Remote • $264k - $277k / year • 3w ago

Utilization Management remote Physician reviewer MD DO Neurology UM PERM

3w ago

Apply

Medical Director

Murtech Staffing & Solutions • Contract • Remote (United States) • 4d ago

Utilization Management medical director remote MD DO

4d ago

Apply

Medical Director - Addiction Medicine

Elevance Health • Full-time • Remote (United States) • $247.84k - $446.11k / year • 4d ago

Utilization Management medical director remote Utilization review Addiction Medicine Psychiatrist Internist

4d ago

Apply

Physician Reviewer - Utilization Management

Oscar Health • Full-time • Remote (New York, United States) • $211.20k - $277.20k / year • 6d ago

Utilization Management remote Physician reviewer MD DO

6d ago

Apply

Medical Director, Children in State Custody (Child Psychiatrist), Remote NM

Magellan Health • Full-time • Remote • $200.28k - $360.50k / year • 6d ago

Utilization Management medical director remote Medicare Medicaid Adolescent Psychiatrist Commercial

6d ago

Apply

Health Advocate

UnitedHealth Group • Full-time • Remote (Dallas, Texas, United States) • $20.38 - $36.44 / hour • 6d ago

Utilization Management remote Health Advocate

6d ago

Apply

Independent Physician Reviewer – Skilled Nursing Care: Geriatrician, Physical Medicine and Rehabilitation, Palliative Care, and/or IM/Hospitalist -National Panel (Remote, 1099)

RediMinds, Inc • Contract • Remote • 6d ago

Utilization Management remote Physician reviewer 1099 contract Internal medicine Utilization review Hospitalist Independent Nursing Care Palliative Car National Panel

6d ago

Apply

Director of Product, Behavioral Health - Remote

UnitedHealth Group • Remote (Minnetonka, Minnesota, United States) • $134.60k - $230.80k / year • 1w ago

Utilization Management remote Director Behavioral Health Product, Behavioral Health

1w ago

Apply

Medical Director National OP Medicare

Ladders • Full-time • Remote (United States) • $223.80k - $313.10k / year • 1w ago

Utilization Management medical director remote Medicare National OP Medicare

1w ago

Apply

Medical Director

The Judge Group • Contract • Remote (United States) • from $125 / hour • 1w ago

Utilization Management medical director remote medical review LTSS Medical Director Masachusetts

1w ago

Apply