Student Veterans of America Jobs

Welcome to SVA’s jobs portal, your one-stop shop for finding the most up to date source of employment opportunities. We have partnered with the National Labor Exchange to provide you this information. You may be looking for part-time employment to supplement your income while you are in school. You might be looking for an internship to add experience to your resume. And you may be completing your training ready to start a new career. This site has all of those types of jobs.

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Job Information

Concentra Physician Psychiatrist Telecommute Medical ReviewStream in Denver, Colorado

Physician Psychiatrist Telecommute Medical ReviewStream Location

US-CO-Denver

Job ID 285369

Pos. Category Medical - Medical Review - UR

Pos. Type Contract Overview

Are you an accomplished Board Certified Psychiatrist? Are you passionate about your work/life balance? We are seeking flexible and experienced physicians for our medical reviewstream division. This telecommute role provides the ability for you to customize your schedule and caseload within a Monday - Friday work week and within business hours. Create a flexible work schedule and be compensated on a per case basis as a 1099 independent contractor. Candidates must have a CO license and a Level 1 or Level 2 Accreditation. JOB SUMMARY: Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations.

Responsibilities

MAJOR DUTIES AND RESPONSIBILITIES:

  • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical Leave Act (FMLA), Group health and workers' compensation claims.
  • Meets (when required) with Concentra Physician Review Medical Director to discuss quality of care and credentialing and state licensure issues.
  • Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job.
  • Returns cases in a timely manner with clear concise and complete rationales and documented criteria.
  • Telephonically contacts providers and interacts with other health professionals in a professional manner. Discusses the appropriate disclaimers and appeal process with the providers.
  • Attends orientation and training
  • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits.
  • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer reviewed literature that support sound and objective decision making and rationales in reviews.
  • Provides copies of any criteria utilized in a review to a requesting provider in a timely manner

Qualifications

EDUCATION/CREDENTIALS:

-Current, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer. -Must be in active medical practice to perform appeals

JOB-RELATED EXPERIENCE: Post-graduate experience in direct patient care

JOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills -Demonstrated ability to perform review services. -Ability to work with various professionals including members of regulatory agencies, carriers, employers, nurses and health care professionals. -Medical direction shall also be provided consistent with the requirement that the physician advisor shall not have a financial conflict of interest -Must present evidence of current error and omissions liability coverage for job duties and activities performed -Managed care orientation -Knowledge of current practice standards in specialty -Good negotiation and communication skills

WORKING CONDITIONS/PHYSICAL DEMANDS: -Phone accessability -Access to a computer to complete reviews -Ability to complete cases accompanied by a typed report in specified time frames -Telephonic conferences This job requires access to confidential and sensitive information, r quiring ongoing discretion and secure information management. Concentra is an Equal Opportunity Employer M/F/Disability/Veteran Concentra's Data Protection Commitment * Concentra is committed to protect patient data and to ensure privacy of personal and medical information. *... For full info follow application link.

EOE, including disability/veterans

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