Medical Expert Reviewer

20 hours ago


Bloomington, Illinois, United States Maximus Federal Full time
Job Summary

Maximus Federal is seeking a highly skilled Medical Expert Reviewer with expertise in Cardiac Electrophysiology to join our team. As a Medical Expert Reviewer, you will play a critical role in ensuring the quality of healthcare services provided by the Department of Veterans Affairs (VA).

Key Responsibilities
  • Peer Review for Quality Management: Conduct thorough reviews of clinical decisions and actions to ensure they meet the standard of care.
  • Provider Qualifications: Evaluate providers' qualifications, including their licensure, certification, and experience in the relevant specialty.
  • Case Review: Review medical records and provide expert opinions on the quality of care provided.
  • Communication: Collaborate with healthcare providers, administrators, and other stakeholders to ensure seamless communication and coordination of care.
Requirements
  • Active license in any state
  • 20 hours of direct patient care per month
  • Board Certification within exact specialty requested
  • MUST have National Provider Identifier (NPI) number
Preferred Qualifications
  • 3-year experience in appropriate specialty post training (non-MD/DO)
  • 5-year experience in appropriate specialty post training (MD/DO)
  • Veteran Affairs Clinical Peer Review (VACPR)
Compensation
  • $150/cs for Audit Reviews
  • $185/cs for Clinical Appeals (rare)
  • $150/cs for Executive Summary Reports
  • $375/cs for Facility-Requested Review
  • $185/cs for Medical Advisory Opinion
  • $150/cs for Routine Management Reviews
About the Role

This is a remote position, and you will be required to obtain a Personal Identify Verification (PIV) card and fingerprints. Maximus Federal will support you with this requirement.



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