Maximus · 8 hours ago

Pediatric Infectious Disease

United States

Contract

Remote

Senior Level

5+ years exp

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Business Process Automation (BPA)Consulting

Hiring Manager

Keith Stewart

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Responsibilities

Medical Expert Reviewer-Medical Expert Judgement Reviews determining final decision based off enrollee’s denial of treatment-coverage denied by the CA DMHC.

Reviews-are based off Medical Necessity and Experimental/Investigational

Specialty Driven-Expert within the Specialty Requested

Deliverables: No direct defined evidence standard or guidelines

Templates will be used to complete reviews

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

MD/DO licensePediatric Infectious DiseaseBoard CertificationMedical Necessity ReviewExperimental/Investigational ReviewsDirect patient careWeb-based portal accessReview Training