Peer Reviewer – Pediatric Gastroenterology Physician
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Job Description
Remote pediatric gastroenterology physician conducting independent medical necessity and quality-of-care reviews for iMPROve Health. Applying specialty expertise to support healthcare quality and professional standards.
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
- Perform independent external medical reviews remotely on an ad hoc basis
Requirements:
- Must hold an unrestricted medical license in any U.S. state
- Board certification required, if applicable, through ABMS, AOA, or another nationally recognized board
- At least five (5) years of full-time equivalent experience providing direct clinical care to patients
- Direct clinical care experience within the past three (3) years
- Knowledge of the issue under review or current evidence-based clinical guidelines and novel treatments
- 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 of adverse changes in licensure or certification status
- Cannot have current employment or affiliation with any Veterans Affairs hospital, health care system, or medical center when applying for 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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