Hand Surgeon Medical Review Stream PhysicianConcentra • Dallas, TX, United States
serp_jobs.error_messages.no_longer_accepting
Hand Surgeon Medical Review Stream Physician
Concentra • Dallas, TX, United States
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_descriptionReviews 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 Board certified MD, DO, with an excellent understanding of network services and managed care, appropriate utilization of services and credentialing, quality assurance and the development of policies that support these services. 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 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 Phone accessability Access to a computer to complete reviews Ability to complete cases accompanied by a typed report in specified time frames Telephonic conferences Concentra is committed to protect patient data and to ensure privacy of personal and medical information. Every Concentra colleague has the responsibility to adhere to data protection principles. If a colleague's role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information.
Hand Surgeon Medical Review Stream Physician
Location
US-TX-Dallas
Job ID
306938
Pos. Category
Medical - Medical Review - UR
Pos. Type
Contract
Recruiter : Full Name : First Last
Claudia Palomino
Overview
Are you an accomplished Board Certified physician in one of the below specialties? Preferred c andidates will have a TX license.
General Surgery
- Neurologist
- Orthopedic Surgery with hand or spine specialty
- Physical Medicine & Rehabilitation
- Plastic Surgery
- Podiatrist
- Pain Medicine
- Neurosurgeon
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.
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 :
Qualifications
EDUCATION / CREDENTIALS :
JOB-RELATED EXPERIENCE :
Post-graduate experience in direct patient care
JOB-RELATED SKILLS / COMPETENCIES :
WORKING CONDITIONS / PHYSICAL DEMANDS :
This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
Concentra is an Equal Opportunity Employer M / F / Disability / Veteran
Concentra's Data Protection Commitment
Additional Data
This position is an independent contractor role for Concentra.
Concentra is an Equal Opportunity Employer, including disability / veterans
serp_jobs.job_alerts.create_a_job
Physician Hand Surgeon • Dallas, TX, United States
Job_description.internal_linking.related_jobs
PURE Oral Surgery is the exclusive provider of oral surgery services to multiple private practices and to all MINT Dentistry offices.
Pure is led by our esteemed Chief Oral Surgeon, Dr.Michael Ellis...serp_jobs.internal_linking.show_more
Texas Hand and Arm Center, a well-established and successful private practice hand surgery practice located in Dallas Texas, seeks a highly skilled and motivated Orthopedic Hand Surgeon to join our...serp_jobs.internal_linking.show_more
Texas Hand and Arm Center, a well-established and successful private practice hand surgery practice located in Dallas Texas, seeks a highly skilled and motivated Orthopedic Hand Surgeon to join our...serp_jobs.internal_linking.show_more)
Texas Hand and Arm Center, a well-established and successful private practice hand surgery practice located in Dallas Texas, seeks a highly skilled and motivated Orthopedic Hand Surgeon to join our...serp_jobs.internal_linking.show_more
Surgery - Cardiothoracic OpportunityDallas, TX more information on this Surgery - Cardiothoracic opening and others like it through Metropolis, a Provider Engagement Platform that connects you with...serp_jobs.internal_linking.show_more
TravelNurseSource is working with Mindlance Health to find a qualified Med / Surg / Tele RN in Allen, Texas, 75013!.ID : 74229204 Shift : NIGHTS - 12HR : 7p-730a with weekends and holidays as needed Des...serp_jobs.internal_linking.show_more
Nightingale Nurses is seeking a travel nurse RN Med Surg for a travel nursing job in Plano, Texas.Job Description & Requirements.
You may not realize it, but as an RN with real world hospital ex...serp_jobs.internal_linking.show_more
UT Southwestern Medical Center in Dallas, Texas is seeking a Board-Certified / Board-Eligible Orthopaedic Hand Surgeon to join its expanding Department of Orthopaedic Surgery.This clinical faculty po...serp_jobs.internal_linking.show_more
LocumJobsNetwork is working with Weatherby Healthcare to find a qualified General Surgery MD in Arkansas!.Get in touch with a Weatherby consultant today to learn more about this and other opportuni...serp_jobs.internal_linking.show_more
UT Southwestern Medical Center in Dallas, Texas is seeking a Board-Certified / Board-Eligible Orthopaedic Hand Surgeon to join its expanding Department of Orthopaedic Surgery.This clinical faculty po...serp_jobs.internal_linking.show_more
Vetted is seeking a RN - Med Surg for a travel job in Dallas, Texas.The job was posted about 1 month ago.The assignment starts on ASAP and is 13 weeks long with 13 hour shifts 3 days a week.You mus...serp_jobs.internal_linking.show_more
Infectious Disease physician job in Texas : .We are seeking an Infectious Disease physician for a group practice opportunity in the Dallas Fort Worth area.
You will be offered a competitive compensat...serp_jobs.internal_linking.show_more
Texas hospital only one hour to Dallas seeks Orthopedic Surgeon to join an established practice.This is the area's preferred multi-specialty medical group that is physician-led with its own board o...serp_jobs.internal_linking.show_more
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United Sta...serp_jobs.internal_linking.show_more
Trustaff is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Allen, Texas.Job Description & Requirements.
As a MS / Telemetry RN, you'll provide care for adult patien...serp_jobs.internal_linking.show_more
Highly respected, well-established multi-office, multi-doctor Oral and Maxillofacial Surgery practice seeking an associate position leading to partnership in Dallas Metroplex area.Position availabl...serp_jobs.internal_linking.show_more
Are you an Anesthesiologist, searching for your next exciting locum tenens opportunity? This position with one of VISTA's healthcare partners in Dallas, Texas might just be the opportunity for you!...serp_jobs.internal_linking.show_more
Non-profit Health System seeking an Orthopedic Hand Surgeon Tyler Texas! (1.Raymond Stiles (843-574-8233) raymond@nowhealthcare.
The Health System is an award-winning integrated delivery system.Clin...serp_jobs.internal_linking.show_more
Oral Surgeon
PURE Oral Surgery • Dallas, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Hand Surgeon Opportunity with Established Practice in Dallas, TX
Tenet Healthcare Corporation • Dallas, TX, US
serp_jobs.job_card.permanent
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Orthopedics - Hand Surgery Physician
Tenet Healthcare • Dallas, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Orthopedic Hand Surgeon (Ortho Only)
American Society for Surgery of the Hand (ASSH) • Dallas, TX, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Physician / Surgery - Cardiothoracic / Texas / Permanent / Surgery - Cardiothoracic Opening, Dallas,
Confidential • Dallas, TX, US
serp_jobs.job_card.permanent
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Travel Nurse RN - Med / Surg / Telemetry - $1,696 per week in Allen, TX
TravelNurseSource • Allen, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Travel Medical-Surgical Ortho-Trauma RN (Telemetry)
Nightingale Nurses • Plano, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Orthopedics - Hand Surgery Physician
UT Southwestern Medical Center • Dallas, Texas, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Locum Physician (MD / DO) - Surgery - General / Other in Arkansas
LocumJobsNetwork • All Cities, AR, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Orthopaedic Hand Surgeon
University of Texas Southwestern Medical Center • Dallas, TX, US
serp_jobs.job_card.permanent
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
RN - Med Surg in Dallas, Texas - $1,463 / week
Vetted Health • Dallas, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Infectious Disease
SourceMD • Dallas, Texas, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Orthopedics Physician
The Curare Group, Inc • Plano, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Physician / Surgery - Orthopedics / Texas / Permanent / Associate Medical Director - Orthopedic Surgery - 100% Remote Job Job
eviCore healthcare • Dallas, Texas, US
serp_jobs.filters.remote
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Travel Nurse RN - Med Surg / Telemetry
Trustaff • Allen, TX, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Oral and Maxillofacial Surgeon
DFW Oral and Maxillofacial Surgery PC • Dallas, US
serp_jobs.job_card.part_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Anesthesiology Physician
VISTA Staffing Solutions • Dallas, US
serp_jobs.job_card.permanent
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Orthopedic Hand Surgeon
NOW Healthcare Recruitment • Town of Texas, WI, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted