Physician Specialist

Harrisburg, PA - USA

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

Job Details

PA Harrisburg - Office of Medical Assistance Programs - Harrisburg PA

Hybrid

Contractor

Professional Degree

Day

Medical Physician & Advanced Practice Provider

Description

MHM Solutions a Centurion company is proud to be the provider of healthcare staffing solutions to state agencies within the Commonwealth of are currently seeking an full-time Physician Specialist to join our team providing non-direct care for the Office of Medical Assistance Programs (OMAP) in Harrisburg PA. This position is 37.5 hours/week with at least 2 days per week in office plus remote work.

The Physician Specialistwill conduct prospective concurrent and retrospective review of any assigned adult or pediatric inpatient and outpatient medical cases covered by the Department including but not limited to: inpatient admissions; procedures performed in a physicians office Short Procedure Unit or Ambulatory Surgical Center; home health services; medical supplies; and/or diagnostic studies or procedures. The Physician Specialist is also 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. It will be the physicians responsibility 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 there will be the requirement 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.

Qualifications

Qualifications:

MD or DO: Active unrestricted Pennsylvania medical license and DEA;
BE/BC
All qualified candidates will successfully complete a thorough background and hiring process.

This role is 37.5 hours/ offer competitive compensation for our independent more information please contact Physician Recruiter Jesse Krasley at or call directly at . indmhm

Required Experience:

Unclear Seniority

Job Details PA Harrisburg - Office of Medical Assistance Programs - Harrisburg PA Hybrid Contractor Professional Degree Day Medical Physician & Advanced Practice ProviderDescription MHM Solutions a Centurion company is proud to be the provider of healthcare staffing solutions to state agencies withi...