Offer summary

Qualifications:

Active medical license in New Jersey., Board certification in relevant medical specialty., Experience with utilization management and prior authorization processes., Ability to review cases based on medical criteria and guidelines..

Key responsibilities:

Review pre-authorization cases according to established guidelines.

Participate in peer-to-peer calls when required.

Conduct medical necessity reviews based solely on medical criteria.

Manage a caseload of approximately 40 cases per day remotely.

Job description

Dane Street is an Independent Review Organization and a national provider of Group Health Review services (among other offerings). We are expanding our physician panel, resulting in opportunities for nontraditional physician work and supplemental income. This is a telework opportunity for physicians providing a caseload customized to your schedule.

Our physician panel comprises independent contract reviewers (1099) compensated on a percase basis. We are looking for reviewers with an active license to address the medical necessity of treatment requests and, in appeals, the medical necessity of previously denied services.

The expectations for this role include:

Initial availability of each physician between 8:00 p.m. and 5:00 p.m. Eastern Time. 8hour shift.

Working within the clients system, with paid training provided in advance of the start date. We will coordinate a suitable time for this training with you.

Reviewing preauthorization cases in accordance with MCG guidelines.

Participating in peertopeer calls when required.

Conducting reviews solely based on medical criteria.

Producing an expected 40 cases per day.

Utilizing a laptop to access the clients AWS system.

Requirements:

Hold an active NJ license

Has currently or prior experience with UM experience dealing with Prior Authorization in UM platforms.

Training and onboarding can be completed in less than 1 week, and you can start earning compensation for reviews while maintaining your active practice.

Current, unrestricted Medical License

Board Certified

Benefits

Independent consultant role allows for schedule flexibility and predictable work hours. You choose services and case types, dictate volume, and conduct this work based on your scheduled availability.

No doctorpatient relationship is established, and no treatment is provided. These are advisoryonly opinions.

Dane Street offers a streamlined case flow and a userfriendly work portal. We facilitate all communication, organize and sort all medical records, support all administrative processes, prep cases extensively, and ensure the quality and timely delivery of all determinationsreports.

A chronological listing of medical records as well as all treatment guidelines used to make a determination are provided in an easy, clicktoview format.

Dane Street offers initial training as well as an ongoing point of contact should you have any questions about completing reviews.