iMPROve Health is an seeking an Orthopedic Surgery Non-Spine physician to join our team in conducting independent medical reviews. As a peer reviewer, you’ll play a vital role in enhancing the quality of health care by applying your clinical expertise to evaluate cases for medical necessity and quality of care.

This is a flexible, remote opportunity for clinicians who are passionate about maintaining the integrity of their specialty and supporting evidence-based practice.

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.

DUTIES AND 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.

QUALIFICATIONS:

• Medical License: Must hold an unrestricted medical license in any U.S. state.
• Board Certification: Required (if applicable), through a board recognized by:
  • The American Board of Medical Specialties (ABMS),
  • The American Osteopathic Association (AOA), or
  • Another nationally recognized board granting certification.
• Clinical Experience:
  • Have at least five (5) years full-time equivalent experience providing direct clinical care to patients.
  • Have experience providing direct clinical care to patients within the past three (3) years.
  • Knowledgeable of the issue under review, or of the current, evidence-based clinical guidelines and novel treatments for the medical or behavioral health condition, disease, treatment, or procedure under review.
  • Have the 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.

TECHNOLOGY REQUIREMENTS:

• Reliable Wi-Fi access.
• Proficiency with Microsoft Word.
• Access to a computer compatible with iMPROve Health’s IT systems.

OTHER REQUIREMENTS:

• Must complete the electronic credentialing application and receive organizational approval prior to performing a case review.
• Must complete a conflict of interest attestation upon credentialing and prior to performing a case review.
• Active hospital medical staff privileges may be required, as applicable.
• Notify the organization in a timely manner of an adverse change in licensure or certification status, including board certification status.
• Cannot have current employment or affiliation with any Veterans Affairs (VA) hospital, health care system, or medical center if applying to perform VA-related peer reviews.

EOE/VET/Disability