Physical Medicine & Rehabilitation Medical Review Stream Physician

🔥 8 minutes ago

🏄 California – Remote

infoinfo

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

Where this job comes from

Posted on Concentra's careers page, not through a job board

First seen by Remote Rocketship 8 minutes ago

Logo of Concentra

Concentra

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 health claims and medical files • Provide medical interpretation and decisions regarding appropriateness of services • 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 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 with other health professionals • Explain disclaimers and the appeal process to providers • Attend orientation and training • Identify and respond to quality assurance, complaints, regulatory, deposition, court appearance, and audit matters • Identify, critique, and use current criteria, national/state/professional guidelines, and peer-reviewed literature • Provide requested review criteria copies to providers in a timely manner

🎯 Requirements

• Board certified MD or DO in Physical Medicine & Rehabilitation • Current, unrestricted clinical license(s); candidates must have a California license • Board certification by the American Board of Medical Specialties or American Board of Osteopathic Specialties • Must be in active medical practice to perform appeals • Post-graduate experience in direct patient care • Demonstrated computer skills and telephonic skills • Demonstrated ability to perform review services • Ability to work with regulatory agencies, carriers, employers, nurses, and healthcare professionals • No financial conflict of interest • Evidence of current errors and omissions liability coverage for job duties and activities performed • Managed care orientation • Knowledge of current practice standards in specialty • Good negotiation and communication skills • Phone access • Access to a computer to complete reviews • Ability to complete cases with a typed report within specified time frames • Ability to participate in telephonic conferences • Ongoing discretion and secure management of confidential and sensitive information

🏖️ Benefits

• Telecommute role • 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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