This physician reviewer role focuses on hematology-oncology case reviews for treatment coverage decisions, with attention to medical necessity and whether services are experimental or investigational. Work is fully remote and completed through a web-based portal using a personal computer, with training provided on the first few cases.
Key Responsibilities
- Conduct expert medical reviews to support final coverage determinations.
- Evaluate requests for treatment based on medical necessity criteria.
- Assess whether requested services are experimental or investigational.
- Review cases within the hematology-oncology specialty scope.
- Complete standard and expedited reviews within required turnaround times.
- Use provided templates to document review findings and decisions.
- Participate in initial case training and feedback with a trainer.
Required
- MD or DO degree with active medical license.
- Board certification in hematology-oncology.
- At least 5 years of post-training experience in the relevant specialty.
- Ability to provide at least 24 hours of direct patient care per week.
Benefits & Perks
- 100% remote work.
- Independent contractor 1099 arrangement.
- Paid per review, with different rates for standard and expedited cases.
- Training support for the first 3-5 cases.
- Flexible training scheduled around reviewer availability.
- Web-based portal workflow.