Medical Reviewer Remote Jobs in Georgia (US)
This page tracks remote medical reviewer openings that are location-eligible for Georgia.
This page tracks remote medical reviewer openings that are location-eligible for Georgia.
Open jobs
946
Hiring companies this week
8
Salary sample
Not enough data
Jobs added last hour
0
946 Jobs
438 Companies
Banyan Treatment Centers operates 18+ locations across the U.S. with accreditation from The Joint Commission and over 1,600 employees delivering compassionate care. As a Collections Specialist, you will: Join a Mission-Driven Organization. Support Financial Sustainability. Grow with an Expanding Company. Apply Now: Join Banyan Treatment Centers as a Collections Specialist and help us sustain high-quality behavioral healthcare through diligent, ethical collections practices. Apply today and take the next step in your revenue cycle career with a leading national provider. EOE
Role Description Banyan Treatment Centers is seeking a licensed clinician to serve as a Clinical Review Specialist within our Admissions team. In this role, you'll function as a key clinical checkpoint in the admissions process by: - Evaluating prospective clients to determine medical and clinical appropriateness for treatment. - Coordinating with site clinical and medical leaders. - Helping ensure every admission decision is grounded in quality, safety, and the right fit for the individual. This is a role for a clinician who brings sound independent judgment, thrives in a collaborative environment, and understands that the decision to admit, or not, has real consequences for the people we serve. Qualifications - Active clinical licensure — RN or LPN. - Ability to independently assess medical and psychiatric presentation and make sound clinical recommendations. - Strong written and verbal communication skills; professional and composed across clinical and cross-functional settings. - Availability for evening and weekend coverage as needed. - Ability to maintain confidentiality and follow all HIPAA and regulatory guidelines. - Preferred: Experience in behavioral health, substance use treatment, or psychiatric settings. - Preferred: Familiarity with admissions or utilization review processes. - Preferred: Experience with Salesforce or similar CRM documentation platforms. - Preferred: Lived or professional experience with recovery is genuinely valued. Requirements - Clinical judgment — Assess medical and psychiatric presentations with confidence, know when to escalate, and make defensible decisions that put patient safety first. - Integrity & accountability — Do what you say you'll do. The people on the other end of the review are counting on it. - Communication — Communicate clearly with clinical and medical leaders, document accurately, and convey complex clinical information in a way that moves the process forward. - Empathy with professionalism — Engage with prospective clients and families respectfully and without judgment, while maintaining the objectivity the role demands. - Adaptability — Stay grounded when priorities shift, and bring solutions, not just problems. Key Responsibilities - Review admissions pre-screens to determine clinical and medical appropriateness for treatment. - Ensure all clinical and medical screening criteria are met prior to admission approval. - Seek medical approval for prospective clients presenting with medical conditions; obtain clinical approval for those with identified psychiatric needs. - Communicate with site clinical and medical leaders to support admission decisions and patient safety. - Integrate clinical expertise within the multidisciplinary admissions team to promote quality care. - Facilitate access to services within Banyan's continuum of care; connect clients with appropriate external providers when internal services are not the right fit. - Complete timely, accurate tracking and documentation of clinical reviews in Salesforce. - Maintain strict confidentiality of all client information in accordance with HIPAA standards. - Adhere to ethical and behavioral standards of conduct and all applicable facility policies. Benefits - Flexible Schedule. - Part-Time with Path to Full-Time. - Evenings & Weekends as Needed.
Role Description We are seeking a professional and customer-focused Virtual Medical Receptionist / Prior Authorization Specialist to support a busy healthcare practice. This is a patient-facing role requiring excellent communication skills, strong organizational abilities, and experience with medical office workflows. Ideal Candidate - Professional and confident on camera. - Friendly, patient-focused, and service-oriented. - Detail-oriented and highly organized. - Comfortable working in a fast-paced remote environment. - Reliable, proactive, and able to manage multiple responsibilities simultaneously. Key Responsibilities - Serve as the first point of contact for patients via phone and video. - Schedule new and follow-up appointments and manage provider calendars. - Handle inbound and outbound patient communications. - Submit, track, and follow up on prior authorization requests. - Verify insurance eligibility and benefits. - Maintain accurate patient records and documentation. - Coordinate with providers, insurance companies, and patients regarding authorizations and appointments. Qualifications - Fluent English and Spanish communication skills (American-accented English preferred). - Minimum 2 years of experience in a medical office, medical reception, or healthcare administrative role. - Experience with appointment scheduling and patient coordination. - Prior Authorization and Insurance Verification experience strongly preferred. - Comfortable interacting with patients through video and phone platforms. - Strong customer service, multitasking, and organizational skills. - Comfortable using computers, iPads, and healthcare software systems. Requirements - This is a full-time contractor position (40 hours per week). - Pay rate of $6 - $7 per hour depending on skillset and experience. - Schedule is Monday through Friday, from 8 AM to 5 PM US Time. Benefits - If you have a passion for helping patients and experience supporting healthcare operations, we encourage you to apply.
Title : Hmong Document Reviewer Location: Atlanta United States Employment Type: Full Time, Mid-Level Department: Legal As a CGS Hmong Chinese Document Reviewer you will play a key role in supporting various aspects of the company's litigation portfolio including eDiscovery activities, workflow management, and litigation support. CGS is seeking an experienced Hmong Chinese Reviewer to join a fast paced and extremely active in-house legal team. CGS brings motivated, highly skilled, and creative people together to solve government’s most dynamic problems with cutting edge technology. To carry out our mission, we are seeking candidates that are excited to contribute to government innovation, appreciate collaboration, and can anticipate the needs of others. Here at CGS, we offer an environment in which our employees feel supported, and we encourage professional growth through various learning opportunities. Skills and attributes for success: - Conduct research and draft responses for a variety of post-conviction motions - Conduct research and draft memorandums on questions of law for direct appeals pending before the court and pretrial motions for criminal cases pending at the Federal Court. - Examines, prepares, and processes a wide variety of technical legal documents that are characteristically voluminous and complex in format. Reviews incoming materials and determines the need for assembly and preparation of a variety of legal documents, e.g., motions, orders, answers, pleadings, subpoenas, etc. Obtains needed information from case files, law enforcement agencies, civil client agencies, or other sources, and submits completed legal documents to the appropriate client assistant attorney for review and approval. Prepares such legal actions as indictments, complaints, search warrants, judgments, applications, notices, affidavits, summonses, subpoenas, rules to show cause, proofs of claim, motions for summary judgment, dismissals, satisfactions of judgment, etc. Ensures legal documents are in conformance with rules governing style and format; - Provides assistance to client attorneys in preparing trial notebooks, assembling jury instructions, compiling witness and exhibit lists. Prepares discovery for plaintiffs and/or defendants in accordance with governing rules and regulations and with the approval of the assigned attorneys. Uses original and online legal resources to verify citations and statutory references contained in legal documents and to ensure citations are complete and consistent with source material; - Composes original letters not requiring legal interpretations, but that require a good working knowledge of legal and administrative procedures and terminology; - Produces a variety of written documents and materials utilizing a wide range of office software applications; - Establishes and maintains a variety of files for client assistant attorneys. Searches legal reference files for information needed by client assistant attorneys in conducting interviews and preparing correspondence. Assemble exhibits, affidavits, and other legal documents from file material. Assembles and organizes files and records material for disposition or transfer to records depositories in accordance with established procedures; and - Produces a variety of written documents and materials utilizing a wide range of office software applications. For example, assignments may include integrating output from different software types, e.g., tables produced by database applications and charts and graphs produced by electronic spreadsheet applications, into word processing or desktop publishing text. Qualifications: - Must have three to five years of progressively more responsible experience on litigation support projects including proven capabilities and communication skills to successfully interact with clients and attorneys. - Requires sound working knowledge of federal and state court systems, legal research procedures, and legal research resources. - Requires excellent written and oral communication skills and thorough knowledge of legal research tools such as LEXIS and Westlaw. - Must have hands-on familiarity with a variety of computer applications, including word processing, databases (such as document review and file management systems), spreadsheets, and imaging. - Role also requires hands-on familiarity with ESI tools and knowledge of eDiscovery procedures and resources. - Requires Law Degree Our commitment: Contact Government Services (CGS) strives to simplify and enhance government bureaucracy through the optimization of human, technical, and financial resources. We combine cutting edge technology with world-class personnel to deliver customized solutions that fit our clients’ specific needs. We are committed to solving the most challenging and dynamic problems. For the past seven years we’ve been growing our government-contracting portfolio, and along the way we’ve created valuable partnerships by demonstrating a commitment to honesty, professionalism, and quality work. Here at CGS we value honesty through hard work and self-awareness, professionalism in all we do, and to deliver the best quality to our consumers mending those relations for years to come. We care about our employees. Therefore, we offer a comprehensive benefits package: - Health, Dental, and Vision - Life Insurance - 401k - Flexible Spending Account (Health, Dependent Care, and Commuter) - Paid Time Off and Observance of State/Federal Holidays Contact Government Services, LLC is an Equal Opportunity Employer. Applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. #CJ $60 - $75 an hour
At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. Proud to be an equal opportunity workplace. Comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned, and promoted without regard to protected characteristics.
Role Description Are you a Nurse Practitioner ready to transform lives and make a real difference for patients with complex kidney conditions? DaVita IKC is looking for a passionate NP to join our team, helping patients navigate a challenging healthcare system while receiving holistic, integrated care in Baltimore, MD. - Location: REMOTE. Occasional travel for meetings or trainings may be required. - Clinical Care & Evaluation: - Complete Comprehensive Health Evaluations (CHEs) to assess and manage comorbid conditions. - Address medical, social, emotional, and financial needs. - Reduce hospitalizations and improve patient outcomes. - Care Management & Disease Progression: - Manage CKD patients, focusing on slowing disease progression, reducing costs, and preventing readmissions. - Utilize prescriptive authority, medication management, and diagnostic interpretation in collaboration with nephrologists and interdisciplinary teams. - Clinical Leadership: - Lead the clinical team to ensure care coordination aligns with medical treatment plans and addresses both medical and psychosocial needs. - Schedule & Benefits: - Monday–Friday, full-time, with the ability to accommodate patient and nephrology partner availability—flexibility is key. - No nights, weekends, or on-call. - Competitive pay, excellent benefits, CEU/CME reimbursement, paid license renewals, and more. Qualifications - Passion for caring for patients with complex, chronic illnesses. - Willingness to adapt as the program evolves. - Minimum 2 years’ experience as a Nurse Practitioner (NP). - Current, unrestricted NP license in state of practice; DEA license or eligibility within 90 days. - Current CPR/BLS certification. - Valid driver’s license and insurance in the state. - Intermediate computer skills (MS Word, Excel, Outlook). - Strong clinical judgment, autonomous decision-making, and expertise in managing complex comorbidities. - Positive, solution-focused attitude, committed to improving patient and team outcomes. - Home office, high-speed internet, and reliable transportation. Requirements - Experience in Value-Based Care or Population Health, including Medicare Advantage documentation and Health Risk Assessments (preferred). - 5+ years’ experience as a Family NP, Primary Care NP, or in Internal Medicine, Cardiology, Nephrology, or Endocrinology (preferred). - Experience managing population health with a focus on reducing hospitalizations (preferred). - Prior experience with Cerner or similar EHR systems (preferred). Benefits - Competitive total rewards package. - 401k match. - Healthcare coverage. - Broad range of other benefits. Company Description At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements.
The Attorney General's Office offers a comprehensive benefits package. For a complete list of benefits provided by The State of Arizona, please visit our benefits page.
Role Description The DES, Division of Child Support Services (DCSS), is seeking an experienced and highly motivated individual to join our team as a Child Support Specialist Case Reviewer with the Administrative Review Unit (ARU). This position is responsible for providing an administrative review of child support cases as assigned pursuant to policy, procedures, federal and state rules, guidelines, and statutory requirements; providing consultative services, technical guidance, and administrative expertise to agency staff during the evaluation of contested actions on administrative enforcement remedies taken statewide. This position may offer the ability to work remotely, within Arizona, based upon the department's business needs and continual meeting of expected performance measures. The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance. Job Duties - Conduct a comprehensive review of child support cases when a requestor contests an administrative enforcement action taken by DCSS. - Conduct a comprehensive review of cases when a support recipient contests the distribution/disbursement of support payments as a result of the Quarterly Notice of Collections. - Adhere to strict local, state, and federal time frames in receiving, acknowledging, processing, and resolving requests for administrative reviews. - Request all related documentation needed to support or deny a request for Administrative Review. Qualifications - Strong understanding of child support arrears, past due child support, assigned support, and administrative actions. - Working knowledge of state and federal regulations, rules, and policies governing child support or family law, legal assisting, administrative, and judicial court practices. - Interviewing techniques and investigative procedures. - Computer software applications, i.e., Google Workspace and Adobe. - Assignment of rights, distribution, and disbursement of child support. Requirements - Adhere to strict state and federal timeframes. - Interpret legal or written documents, court orders, and administrative and judicial court practices. - Meet performance measures, manage time and competing priorities; follow set policies and procedures to ensure timeliness, data reliability, and accuracy. - Learn the Arizona Child Support Services automated case management system. Selective Preference(s) - Working knowledge equivalent to one (1) year of child support enforcement, child support arrears, medical, spousal, state-assigned arrears, administrative actions, and court order interpretation. Pre-Employment Requirements - Successfully pass background and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions. - Arizona Level One Fingerprint Clearance Card. - If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements. - All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify). Benefits - Affordable medical, dental, life, and short-term disability insurance plans. - Participation in the Arizona State Retirement System (ASRS) and long-term disability plans. - 10 paid holidays per year. - Paid vacation and sick time. - Paid Parental Leave - Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child. - Deferred compensation plan. - Wellness plans. - Tuition Reimbursement. - Stipend Opportunities. - Infant at Work Program. - Rideshare and Public Transit Subsidy. - Career Advancement & Employee Development Opportunities.
Role Description Are you a clinically experienced Registered Nurse looking to apply your expertise beyond direct patient care? As a Medical Review Nurse you will play a critical role in strengthening risk management and improving decision-making across our health and accident products. You’ll use your clinical knowledge to evaluate medical records, guide coverage determinations, and support fair, evidence-based appeal outcomes—directly impacting both business outcomes and member experience. This is an opportunity to bring your clinical judgment, analytical thinking, and passion for quality care into a dynamic, fast-paced environment where your insights drive meaningful results. What You’ll Do - Serve as a trusted clinical expert supporting accident and health lines of business - Review medical records and claims to determine coverage and benefit eligibility - Evaluate medical necessity and appropriateness of care based on evidence-based guidelines - Draft clear, defensible written rationales for coverage and appeal determinations - Analyze medical and claims data to identify trends, risks, and improvement opportunities - Assess medical information to determine current and potential risk exposure for coverage decisions - Interpret and apply policy contract language to ensure consistent, accurate determinations - Synthesize complex data from multiple sources to inform business decisions - Maintain strong productivity and quality in a high-volume, fast-paced environment - Collaborate cross-functionally while demonstrating strong independence and accountability Qualifications - Active Registered Nurse (RN) license - Proven ability to analyze and interpret complex medical information and documentation - Strong clinical judgment and decision-making skills - Excellent written and verbal communication skills Requirements - 5+ years of clinical nursing experience - Experience in health insurance, utilization review, medical claims, or appeals - Familiarity with medical coding systems (CPT, ICD-10, HCPCS) and claims documentation - Experience interpreting insurance policy language and applying it in decision-making - Exposure to data analysis and identifying trends within medical or claims data Key Skills & Strengths - Analytical mindset with strong attention to detail - Ability to translate clinical complexity into clear, actionable insights - Strong problem-solving and critical thinking capabilities - Effective time management and ability to prioritize competing demands - Comfortable working both independently and collaboratively Tools & Expertise - Proficiency in Microsoft Office (Excel, Word, Outlook) - Experience working with medical records, physician notes, and evidence-based clinical studies - Ability to interpret Explanation of Benefits (EOBs) and submitted claims Benefits - Compensation offered for this role is $62,100.00 - $103,950.00 annually and is based on experience and qualifications. - Comprehensive technology setup, including a laptop, monitors, headset, keyboard, and mouse. - Monthly connectivity reimbursement for employees eligible to work from home.
This opportunity is available through a leading AI-driven work platform.
Role Description We are sharing a specialised part-time consulting opportunity for experienced visual quality professionals with expertise in: - Film - VFX - Rendering - Lighting - Color grading - Cinematography - Professional photography - Artifact detection - Pixel-level review - Super-resolution video evaluation This role supports current and upcoming remote consulting opportunities focused on: - Video sharpening - Upscaling - Super-resolution review - Frame-by-frame visual quality assessment - Artifact detection - Evaluation template development - High-quality project execution Selected professionals will apply a rigorously trained visual eye to assess whether enhanced video outputs hold up at a professional level across: - Detail - Sharpness - Texture - Color - Temporal consistency Qualifications - Fluent English - 7–10 years of experience in high-end visual evaluation across film, visual effects, professional photography, cinematography, rendering, or related fields - Training from a university or program with a highly respected film, visual effects, digital media, or imaging curriculum - Reliable access to a 4K-resolution monitor for precise pixel-level review - Familiarity with AI tools and workflows, including the ability to generate visual samples for testing and comparison - Ability to translate complex visual details into clear, precise language for captions, review notes, and evaluation templates - Ability to work independently in a remote, project-based environment Requirements - VFX supervisor with strong final image quality review experience - Rendering supervisor with experience reviewing dailies and pixel-level output quality - Lighting supervisor, lighting lead, or lighting artist with strong digital video and cinematic motion judgment - Colorist with deep experience in grading, artifact detection, and visual consistency - Director of photography or cinematographer with expertise in framing, sharpness, and high-resolution image detail - Effects artist, surfacing artist, high-end photographer, director, or digital projectionist with a trained eye for final-output quality Nice to Have - Experience reviewing final image quality for film, VFX, animation, games, commercial photography, or high-end video content - Experience with dailies review, color grading, projection review, visual QC, rendering review, or image finishing - Strong understanding of compression artifacts, grain structure, aliasing, noise, softness, texture fidelity, and high-resolution visual detail - Comfort with frame-by-frame review and structured visual evaluation - Experience creating or reviewing visual benchmarks, comparison samples, or expert evaluation templates Benefits - Apply professional visual quality expertise to structured remote evaluation work - Contribute to high-quality review of video sharpening, upscaling, and super-resolution outputs - Work on assignments aligned with your VFX, rendering, lighting, color, cinematography, photography, or projection background - Use your trained eye to identify subtle image-quality issues that matter at a professional level - Remote structure with competitive hourly compensation Contract Details - Independent contractor role - Fully remote with scheduling aligned to PST through EST working hours - Eligible professionals should be based in the United States depending on project needs - Part-time commitment depending on project availability - Competitive rates between $50–$80 per hour depending on expertise and project scope - Weekly payments via Stripe or Wise - Projects may be extended, shortened, or adjusted depending on scope and performance - Work will not involve access to confidential or proprietary information from any employer, client, or institution About the Platform This opportunity is available through 24-MAG LLC. We connect experienced professionals with remote consulting opportunities across technical, evaluation, and project-based workstreams. By submitting this application, you acknowledge that your information may be processed by 24-MAG LLC for recruitment and opportunity matching in accordance with our Privacy Policy: https://www.24-mag.com/privacy-policy
iMPROve Health is Michigan’s Medicare-designated Quality Improvement Organization, dedicated to improving healthcare across the continuum of care using evidence-based, data-driven strategies. We provide medical consulting and review services, along with data analysis, to federal agencies, state Medicaid programs, public health organizations, healthcare facilities, private health plans, and other third-party payers. Our mission is simple: help healthcare get better.
Role Description iMPROve Health is seeking an addiction medicine physician to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis. As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type. Qualifications - Medical License: 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) - Another nationally recognized board granting certification. - Clinical Experience: - 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. Requirements - 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. Benefits - Make a Difference: Use your clinical knowledge to improve the quality of care patients receive. - Professional Recognition: Join a network of highly respected experts in your specialty. - Competitive Compensation: Receive fair pay for your time and expertise. - Protect Standards of Care: Help uphold the integrity of your profession. - Work Remotely: Review cases from the convenience of your home or office.
iMPROve Health is Michigan’s Medicare-designated Quality Improvement Organization, dedicated to improving healthcare across the continuum of care using evidence-based, data-driven strategies. We provide medical consulting and review services, along with data analysis, to federal agencies, state Medicaid programs, public health organizations, healthcare facilities, private health plans, and other third-party payers. Our mission is simple: help healthcare get better.
Role Description iMPROve Health is seeking a plastic surgeon to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis. As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type. Duties and 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. Qualifications - Medical License: 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). - Another nationally recognized board granting certification. - Clinical Experience: - 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. Technology Requirements - Reliable Wi-Fi access. - Proficiency with Microsoft Word. - Access to a computer compatible with iMPROve Health’s IT systems. Other Requirements - 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. Benefits - Make a Difference: Use your clinical knowledge to improve the quality of care patients receive. - Professional Recognition: Join a network of highly respected experts in your specialty. - Competitive Compensation: Receive fair pay for your time and expertise. - Protect Standards of Care: Help uphold the integrity of your profession. - Work Remotely: Review cases from the convenience of your home or office.
iMPROve Health is Michigan’s Medicare-designated Quality Improvement Organization, dedicated to improving healthcare across the continuum of care using evidence-based, data-driven strategies. We provide medical consulting and review services, along with data analysis, to federal agencies, state Medicaid programs, public health organizations, healthcare facilities, private health plans, and other third-party payers. Our mission is simple: help healthcare get better.
Role Description iMPROve Health is seeking an endocrinologist to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis. As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type. Duties and 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. Qualifications - Medical License: 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). - Another nationally recognized board granting certification. - Clinical Experience: - 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. Technology Requirements - Reliable Wi-Fi access. - Proficiency with Microsoft Word. - Access to a computer compatible with iMPROve Health’s IT systems. Other Requirements - 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. Benefits - Make a Difference: Use your clinical knowledge to improve the quality of care patients receive. - Professional Recognition: Join a network of highly respected experts in your specialty. - Competitive Compensation: Receive fair pay for your time and expertise. - Protect Standards of Care: Help uphold the integrity of your profession. - Work Remotely: Review cases from the convenience of your home or office.
936more opportunities are still waiting for you.Log in now and take your next shot before someone else does.
Stack data is limited for this slice right now.