About us
Toney HealthCare Consulting, LLC is a medium business in HEALTH_CARE_MEDICAL. We are professional and agile.
Our work environment includes:
M.D. ~ Licensed in New York or MD compact license Required
Job Duties:
· Evaluates clinical service requests made by an organization's members and providers, for medical necessity.
· May also provide clinical leadership in other areas of the organization. Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member.
· Participates in the process to evaluate clinical service requests.
· May provide assistance with case management activities.
· Participates in the Physician Review process for peer to peer review and in the appeal process of service denials.
· Other duties as assigned by the Medical Director/ client
Education Requirements:
· Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine REQUIRED.
· 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background.
· Must have understanding of managed care and demonstrate PC proficiency, as file review will be done via computer in most cases. (Note: Position does not provide direct patient care or medical diagnosis.)
**In addition to the physical health medical directors- we are in need of OB-GYN specialty reviewers.
· Job Type: Contract 10-20 hours a week for synchronous positions
Pay: $175.00 - $200.00 per hour
Client training provided
Join our team of dedicated healthcare professionals and make a difference in the lives of our patients. Apply now to be part of our dynamic healthcare environment.
Job Types: Part-time, Contract
Pay: $175.00 - $200.00 per hour
Expected hours: 10 – 20 per week
Benefits:
Schedule:
- Day shift
- Evening shift
- Night shift
- Weekends as needed
Work Location: Remote