Physician Reviewer, Neurological Surgery - NV

This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis. Preferred candidates will hold Nevada Medical License (M.D., D.O.) JOB SUMMARY Physician Reviewer/Advisor utilizes clinical expertise to review, provide interpretation of clinical treatment guidelines and opine on the medical necessity of services/treatment proposed or provided by other healthcare professionals in compliance with client-specific policies, nationally recognized evidence-based guidelines, and standards of care. MAJOR DUTIES AND RESPONSIBILITIES: Reviews all medical records and addresses each question posed utilizing client-specific criteria or other nationally recognized evidence-based criteria Ensures a clear rationale for determination that is concise and contains adequate supporting documentation to substantiate the decision Identifies and employs 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; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes Provides a report and copies of any criteria utilized within the review promptly Returns cases on or before the due date and time specified Completes calls/call attempts as mandated by the state and/or client specifics Maintains proper credentialing, required licenses, and any special certifications and adheres to requirements necessary to perform in the role of Physician Reviewer/Advisor Attends required orientation and training Performs other duties as assigned including identifying and responding to potential quality assurance issues, complaints, and regulatory issues. PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews vi