Maximus is seeking a 100% remote Hematology Oncology MD/DO Reviewer to serve as a Medical Expert Reviewer. This role involves making final decisions on treatment coverage denials by the CA DMHC, based on medical necessity and whether the treatment is experimental/investigational. The position offers an opportunity to provide thorough and professional medical reviews from a remote setting.
Practice Info
• 100% Remote, 1099 position
• Reviews are based off Medical Necessity and Experimental/Investigational criteria
• Specialty Driven-Expert within the Specialty Requested
• Expert Reviewers must use their own personal computer to access a web-based portal
• Review Training –Trainer will work closely with reviewer for the first 3-5 cases
• Templates will be used to complete reviews
Responsibilities
• Determine final decision based off enrollee’s denial of treatment-coverage denied by the CA DMHC
• Conduct reviews based off Medical Necessity and Experimental/Investigational criteria
• Complete reviews using provided templates
Compensation
• Rates per case $150 to $400 per review
• Salary Range $150 to $400 / Hour
Shift & Schedule
• Scheduled Training- based on reviewer’s schedule
Requirements
• Active license
• 24 hours of direct patient care per week
• 5 years’ experience in appropriate specialty post training
• Board Certification
• No visa sponsorship available