Physician Specialist NDC Expert

1 week ago


Harrisburg, Pennsylvania, United States Staff Today Inc Full time
Job Description

Staff Today Inc is seeking a highly skilled Physician Specialist NDC Expert to join our team.

The ideal candidate will be a board-certified physician with expertise in utilization review and quality of care assessments. The successful candidate will serve as a medical reviewer for the Department of Public Welfare, providing thorough and accurate reviews of services for Medicaid recipients.

The key responsibilities of this role include:

  • Conducting prospective, concurrent, and retrospective reviews of inpatient and outpatient medical cases
  • Making determinations regarding medical necessity, place of service, appropriateness, compensability, and quality of care
  • Compiling case findings, preparing summaries, and making recommendations for case disposition
  • Identifying program violations and preparing appealed cases for hearings
  • Assisting in the development of in-house training programs, medically necessary criteria, and quality of care indicators

The successful candidate will possess excellent communication and analytical skills, with the ability to work independently and as part of a team. If you are a motivated and detail-oriented physician with a passion for quality of care, we encourage you to apply for this exciting opportunity.

Requirements:

  • Board certification in a relevant specialty
  • Active Pennsylvania medical license
  • Minimum 20 hours of active clinical practice per month
  • Basic computer skills, including Microsoft Office products

What We Offer:

  • A competitive hourly rate
  • The opportunity to work with a dynamic team
  • Professional development and growth opportunities

Apply now to join our team of dedicated professionals and take the first step towards a rewarding career as a Physician Specialist NDC Expert.



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