Ophthalmologist, Telecommute Medical Review Stream Physician

Job not on LinkedIn

🔥 5 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 15%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Concentra

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🧬 Biotechnology

Healthcare • Healthcare Insurance • Biotechnology

Concentra is a leading provider of healthcare services, focusing on rehabilitation and recovery for patients with critical illnesses and injuries. With an extensive network of inpatient rehabilitation hospitals and outpatient centers across the United States, Concentra is committed to delivering exceptional patient care that promotes healing and quality of life. Their team of over 45,000 healthcare professionals works collaboratively to design personalized treatment plans aimed at restoring function and facilitating a smooth transition from hospital to home.

📋 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 • Provide medical interpretation and decisions regarding the appropriateness of services provided by healthcare professionals • Meet with the Concentra Physician Review Medical Director as required regarding quality of care, credentialing, and state licensure issues • Maintain proper credentialing, state licenses, certifications, and other job requirements • Return cases promptly with clear, concise, complete rationales and documented criteria • Contact providers by telephone and interact professionally with healthcare professionals • Explain applicable disclaimers and appeal processes to providers • Attend orientation and training • Identify and respond to quality assurance, complaint, regulatory, deposition, court appearance, and audit matters • Identify, critique, and use current criteria and resources, including national, state, and professional association guidelines and peer-reviewed literature • Provide requested review criteria copies to providers in a timely manner

🎯 Requirements

• Board-certified MD or DO • Ophthalmologist with board certification by the American Board of Medical Specialties or American Board of Osteopathic Specialties • Current, unrestricted Louisiana clinical license (or restricted license with compliant organizational process) • Must have an LA MD license • Must be in active medical practice to perform appeals • Post-graduate experience in direct patient care • Excellent understanding of network services and managed care, utilization of services, credentialing, quality assurance, and related 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 • Current errors and omissions liability coverage for job duties and activities • Managed care orientation • Knowledge of current practice standards in ophthalmology • Good negotiation and communication skills • Phone access and computer access to complete reviews • Ability to complete cases with typed reports within specified time frames • Ability to handle confidential and sensitive information securely

🏖️ Benefits

• Flexible schedule and customizable caseload within a Monday–Friday work week and business hours • Compensation on a per-case basis as a 1099 independent contractor

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