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iMPROve Health · 3 weeks ago

PEER REVIEWER - PEDIATRIC ORTHOPEDIC SURGEON - REMOTE

United States

Contract

Remote

Senior Level

5+ years exp

iMPROve Health is seeking a Pediatric Orthopedic Surgeon to join our team in conducting independent medical reviews. As a peer reviewer, you’ll play a vital role in enhancing the quality of health care by applying your clinical expertise to evaluate cases for medical necessity and quality of care.

Health CareMedicalNon Profit

Responsibilities

Conduct objective, evidence-based peer reviews of clinical cases

Make final determinations regarding medical necessity and quality of care

Ensure decisions are fair, unbiased, and aligned with current standards of practice

Submit reviews in a timely and professional manner using the IT systems provided

Qualification

Medical LicenseBoard CertificationClinical ExperienceEvidence-based guidelinesMicrosoft Word

Required

Must hold an unrestricted medical license in any U.S. state

Board Certification: Required (if applicable), through a board recognized by: The American Board of Medical Specialties (ABMS), The American Osteopathic Association (AOA), or another nationally recognized board granting certification

Have at least five (5) years full-time equivalent experience providing direct clinical care to patients

Have experience providing direct clinical care to patients within the past three (3) years

Knowledgeable of the issue under review, or of the current, evidence-based clinical guidelines and novel treatments for the medical or behavioral health condition, disease, treatment, or procedure under review

Have the clinical expertise to manage the medical or behavioral health condition or disease under review

Must be actively engaged in direct or virtual patient care for at least 20 hours per week. Administrative work does not qualify

Reliable Wi-Fi access

Proficiency with Microsoft Word

Access to a computer compatible with iMPROve Health's IT systems

Must complete the electronic credentialing application and receive organizational approval prior to performing a case review

Must complete a conflict of interest attestation upon credentialing and prior to performing a case review

Active hospital medical staff privileges may be required, as applicable

Notify the organization in a timely manner of an adverse change in licensure or certification status, including board certification status

Cannot have current employment or affiliation with any Veterans Affairs (VA) hospital, health care system, or medical center if applying to perform VA-related peer reviews