Locum Tenens Family Practice Job PA
alarm 17 days ago
Posted by Medical Search International- MSI
Employer Medical Search International
Medical Search International is looking for a Family Medicine Physician for a residential, intermediate care facilities for people who have intellectual disabilities in PA.
Hours: 8AM-4PM Monday-Friday
Contract End Date: 10/31/2022
- Board Certified in Family Practice Medicine
- Possess an active Pennsylvania medical license
- Demonstrate an understanding of utilization review processes
- Provide utilization and quality reviews of services for the Department.
- Conduct prospective, concurrent and retrospective review of any assigned adult and pediatric inpatient and outpatient medical cases 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; home health services, medical supplies, and/or diagnostic studies or procedures.
- Be responsible for making determinations regarding the medical necessity, place of service, appropriateness, compensability, and/or quality of care of services prescribed for and provided to Medicaid recipients.
- Responsible to review all requests thoroughly and make a qualified determination in accordance with Medical Assistance regulations and criteria.
- Depending on the type of case reviewed, will be required to compile case findings, prepare summaries of case findings; make recommendations for case disposition, identify program violations; prepare appealed cases for hearings; and/or be available to testify at administrative hearings for cases under appeal.
- Assist in the development of in-house training programs, medically necessary criteria, and quality of care indicators.
- Help the Department in determining if any changes should be made to criteria or regulations to better serve Medical Assistance recipients.
For Immediate Consideration please send your CV to firstname.lastname@example.org
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