MHM Services, Inc.

  • Physician- Clinical Reviewer

    Job Locations US-NV-Carson City
    Posted Date 2 weeks ago(1/4/2019 1:33 PM)
    Job ID
    2019-10258
  • Overview

    • Ready for a change of pace, yet rewarding and challenging work? 
    • Use your medical expertise effectively, with no patient interaction or contact.

    The Division of Health Care Financing and Policy (DHCFP) is also known as Nevada Medicaid. The Surveillance and Utilization Review (SUR) Unit monitors providers for fraud, waste and abuse.  Your schedule can be flexible working weekdays, averaging one day a week working at the office in Carson City.

     

    The Primary Care Physician will work on an as needed basis, with the following responsibilities:

    • Review claims data provided by SUR staff to help identify suspicious or potentially fraudulent activity. 
    • Review records from providers for appropriateness, e.g. a claim billed at a high level office visit meets the criteria for such a claim.
    • Provide written attestations and/or testify for hearings on DHCFP's behalf.
    • Offer suggestions for policy improvements when coming across vague or confusing sections during a provider or data review.

    Qualifications

    • Requires board certification and an unrestricted Nevada Medical License for a MD or DO
    • Recent experience in medical coding and billing
    • Ability to do Medicaid policy research
    • Computer skills needed

     

    This Independent Contractor position is through MHM Services, (MHM), a leading national provider of healthcare services to state and local government agencies. MHM has clients in 16 states providing services within 300+ facilities through the efforts of 7,000 employees. From mental health and long-term care to medical and forensic services, our employees are dedicated to providing the highest quality of care for every population they serve.

     

    For consideration and information, please submit your CV to:

     

    Wonona Davis, Physician Recruiter, West Coast Region

    Email: wonona@mhmcareers.com  Phone: 707-266-7788

     

     

    indmhm

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