Physician Specialist - PA Staffing
US-PA
Careers (Attract)
Req #: 38636
Type: Independent Contractor
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Overview: MHM Solutions, a Centurion company, is proud to be the provider of healthcare staffing solutions to state agencies within the Commonwealth of Pennsylvania. We are currently seeking a part-time Physician Specialist to join our team assisting the Bureau of Program Integrity within the Office of Medical Assistance Programs (OMAP). This role is primarily remote, but will occasionally need to report to office in Harrisburg, PA. Responsibilities: The Physician Specialist/Consultant will provide the Bureau of Program Integrity (BPI) with consultation for retrospective medical record reviews of any medical rehabilitation related services covered by the Department including, but not limited to: inpatient admissions, procedures performed in a physician's office, short procedure unit or ambulatory surgical center, outpatient treatment services, home health services, hospice, medical supplies, and/or diagnostic studies or procedures. Consultant shall be responsible for making determinations regarding the medical necessity, place of service, appropriateness, compensability, and/or quality of care services prescribed for and provided to Medical Assistance (MA) recipients. It will be the Consultant's responsibility to review all medical records thoroughly and make a qualified determination in accordance with the Standards of Practice, Office of Medical Assistance regulations and InterQual criteria. Qualifications: * Consultant in this position will serve as a physician reviewer for the Department of Public Welfare, Office of Medical Assistance Programs, Bureau of Program Integrity (BPI) for the period through 11/1/23 thru 10/31/24. * Available as a part-time reviewer for agreed-upon hours per week * Board certified in Physical Medicine and Rehabilitation * Possess an active Pennsylvania medical license * Be in active clinical practice in the area in which the consultant is board certified at least 16 hours per month; * Demonstrate an understanding of utilization review processes; and * Possess basic computer skills, including familiarity with Microsoft Office packages.
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