Spine Surgeon – Telecommute Medical Review

🕒 il y a 1 jour

🏖️ New Jersey – Distant

infoinfo

⏳ Contrat

🟡 Intermédiaire

🟠 Senior

🗣️🇺🇸🇬🇧 Anglais requis

D'où vient cette offre

Publiée sur la page carrières de Concentra, pas via un site d'emploi

Repérée par Remote Rocketship il y a 1 jour

Toujours ouverte sur le site de Concentra. Vérifiée il y a 2 heures.

Logo of Concentra

Concentra

10 000+ employés

🏥 Santé

⚕️ Assurance santé

🧬 Biotechnologie

Healthcare • Healthcare Insurance • Biotechnology

Concentra est un fournisseur de services de santé de premier plan, se concentrant sur la réhabilitation et la récupération des patients souffrant de maladies et blessures critiques. Avec un vaste réseau d'hôpitaux de réhabilitation en hospitalisation et de centres en ambulatoire à travers les États-Unis, Concentra s'engage à offrir des soins exceptionnels favorisant la guérison et la qualité de vie. Leur équipe de plus de 45,000 professionnels de la santé travaille en collaboration pour concevoir des plans de traitement personnalisés visant à restaurer la fonction et faciliter une transition en douceur de l'hôpital à la maison.

Description

• Review medical files and provide recommendations for utilization review, chart reviews, medical necessity, appropriateness of care, return to work, short- and long-term disability, FMLA, group health, and workers’ compensation claims • Meet with the Concentra Physician Review Medical Director regarding quality of care, credentialing, and state licensure issues when required • Maintain proper credentialing, state licenses, certifications, and other requirements • Return cases promptly with clear, complete rationales and documented criteria • Contact providers by telephone and interact with healthcare professionals • Explain applicable disclaimers and appeal processes to providers • Attend orientation and training • Identify and respond to quality assurance, complaints, regulatory issues, depositions, court appearances, and audits • Identify, critique, and use current national, state, and professional guidelines and peer-reviewed literature to support objective review decisions • Provide requested review criteria copies to providers in a timely manner

🎯 Exigences

• Board certified MD, DO, Spine Surgeon, or Neurosurgeon • Current, unrestricted clinical license(s); candidates must have a New Jersey license • Board certification by the American Board of Medical Specialties or American Board of Osteopathic Specialties required for MD or DO reviewers • Must be in active medical practice to perform appeals • Post-graduate experience in direct patient care • Understanding of network services, managed care, utilization of services, credentialing, quality assurance, and policy development • Demonstrated computer and telephonic skills • Demonstrated ability to perform review services • Ability to work with regulatory agencies, carriers, employers, nurses, and healthcare professionals • Must present evidence of current errors and omissions liability coverage • Managed care orientation • Knowledge of current practice standards in the specialty • Good negotiation and communication skills • Phone access and access to a computer to complete reviews • Ability to complete cases with typed reports within specified time frames • Ability to participate in telephonic conferences • Ongoing discretion and secure information management when handling confidential and sensitive information

🏖️ Avantages

• Flexible schedule and caseload within a Monday–Friday work week and business hours • Compensation on a per-case basis as a 1099 independent contractor • Telecommute work arrangement • Independent contractor role • Orientation and training

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