Peer Reviewer – Dentist
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Job Description
Dentist peer reviewer conducting evidence-based medical necessity and quality-of-care reviews. iMPROve Health uses contracted clinical expertise to uphold healthcare standards.
Responsibilities:
- Perform independent external medical reviews remotely on an ad hoc basis as an independent contractor (1099).
- Apply clinical expertise to evaluate cases specific to the reviewer’s specialty, medical necessity, and/or standard of care.
- 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 provided IT systems.
Requirements:
- Must be a Dentist and/or Periodontist with implant experience.
- 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), or another nationally recognized board granting certification.
- At least five (5) years of full-time equivalent experience providing direct clinical care to patients.
- Experience providing direct clinical care to patients within the past three (3) years.
- Knowledge of the issue under review, or current evidence-based clinical guidelines and novel treatments for the relevant condition, disease, treatment, or procedure.
- 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.
- 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 before performing a case review.
- Must complete a conflict of interest attestation upon credentialing and before performing a case review.
- Active hospital medical staff privileges may be required, as applicable.
- Must notify the organization promptly of adverse changes 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.
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