PEER REVIEWER - FAMILY & SPORTS MEDICINE PHYSICIAN - REMOTE at MICHIGAN PEER REVIEW ORGANIZATION – Lansing, Michigan

iMPROve Health is seeking a Family and Sports Medicine Physician to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis. As a peer reviewer, you will apply your clinical expertise to evaluate cases, specific to your specialty, medical necessity and/or standard of care, supporting efforts to enhance the overall quality and integrity of health care and your profession. Please note, this is not an employed position and our contracted fee is based on credential and specialty type.

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