Internal Medicine Physician jobs in United States
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Maximus · 3 weeks ago

Internal Medicine Physician

positionUnited States
timeContract
remoteRemote
senioritySenior Level

Maximus is seeking an Internal Medicine Physician to perform independent reviews based on medical necessity denial disputes for Medicaid beneficiaries. The role involves reviewing inpatient care to determine if it meets medical necessity criteria and requires the completion of specific forms and documentation.

Business Process Automation (BPA)ConsultingEducationGovernmentGovTechHealth CareInformation Technology
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H1B Sponsor Likelynote
Hiring Manager
Breanna Esparza
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Responsibilities

Perform Independent Reviews based on Medical Necessity denial disputes for services that were denied by a managed care organization (MCO) for Medicaid beneficiaries
The goal of a Level of Care review is to determine the medical necessity of inpatient care
The Reviewer should be able to determine if specific dates/inpatient care in question meet the InterQual criteria and Meet/Do NOT meet medical necessity
Review each day of stay to ensure Medical Necessity of Inpatient stay per day that patient is in the hospital
Complete MPR form according to directions on form
Write-up of decision/analysis using the IRAC format
Rationale must integrate facts from the medical records with all cited references according to directions on forms

Qualification

Internal Medicine ExperienceMedical Necessity ReviewsInterQual CriteriaSalesforceIRAC Format

Required

MUST HAVE Internal Medicine /Hospitalist EXPERIENCE
Must have 24 hours of active practice per week

Company

Maximus

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Glassdoor3.5
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Providing government technology services, digitally enabled customer experiences, and clinical health services that change lives.
dateFounded in 1975
location
Mclean, Virginia, USA
people-size10001+ employees
web-link
http://www.maximus.com/

H1B Sponsorship

Maximus has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (39)
2024 (39)
2023 (50)
2022 (42)
2021 (36)
2020 (42)

Funding

Current Stage
Public Company
Total Funding
$7.93M
2010-12-09Post Ipo Equity· $7.93M

Leadership Team

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Elisabeth Schmidt
Senior Vice President
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Michael Mateer
Sr. Vice President, Enterprise Technology
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Recent News

Morningstar.com
Maximus Reports Fourth Quarter and Full Year Results for Fiscal Year 2025
2025-11-20
AP News
Company that monitors addiction treatment for medical providers exiting Montana contract in January
2025-11-12
Business Wire
Maximus Awarded $86 Million Contract to Advance Rapid Capability Development and Operational Readiness for Air Force Cyber Command and Control Systems
2025-11-05
Company data provided by crunchbase