Provide telework utilization review and independent medical review for California workers’ compensation cases, focusing on medical necessity determinations for occupational medicine issues. Reviews are case-based, advisory-only, and completed from your scheduled availability, with written rationale grounded in evidence-based guidelines and medicolegal standards. The work is supported by a streamlined case flow, extensive record preparation, and training resources.
Key Responsibilities
- Conduct independent medical reviews of workers’ compensation treatment requests and appeals.
- Evaluate medical necessity using MTUS, ODG, and other evidence-based guidelines.
- Prepare clear written determinations and medicolegal rationale for each case.
- Review utilization review denials, delays, or modifications through the IMR process.
- Work from organized case files and documentation provided through a web-based portal.
- Complete reviews independently without direct patient care or phone calls.
Required
- Current, unrestricted California medical license.
- Board certification in Occupational Medicine.
- Active clinical practice.
- Experience with the California Independent Medical Review (IMR) process.
Preferred
- Prior California IMR experience.
Benefits & Perks
- Telework opportunity with schedule flexibility.
- 1099 independent contractor role with per-case compensation.
- Work available outside standard business hours.
- No calls required.
- Consistent case volume.
- Training manual provided to support reviews.
- Initial training and ongoing contact for questions.
- Streamlined case flow with administrative support and a user-friendly portal.