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[Remote] Medicaid Peer Reviews

Remote · United Arab Emirates Full-time

Note: The job is a remote job and is open to candidates in USA. Commence is a company focused on data-centric transformation in healthcare, aiming to elevate health outcomes through quality data-driven solutions. They are seeking Physicians (MD/DO) to join their network of clinical reviewers, responsible for conducting independent case reviews and ensuring the quality of care for military members and their families.

Responsibilities

  • Conduct independent, remote case reviews evaluating medical necessity, appropriateness, or quality of care
  • Provide evidence-based assessments and written determinations following established clinical guidelines and review criteria
  • Support case types including: Utilization review, Appeals and hearings, Quality of care and standard of care concerns
  • Uphold the highest standard of clinical integrity, neutrality, and objectivity

Skills

  • Hold an active, unrestricted U.S. license as an MD or DO
  • Board certified in your specialty by an ABMS or AOA-recognized board within the State of Maryland or surrounding states
  • Minimum of 5 years of clinical experience in your specialty post residency or fellowship
  • Currently practicing and seeing patients an average of at least 20 hours per week over the past 30 days
  • Strong written communication skills and attention to detail
  • Ability to review cases objectively and meet turnaround deadlines
  • Comfortable working independently in a secure, remote environment
  • Current High Priority Specialties: Dentistry, Dermatology, Endocrinology, Nephrology, Ophthalmology, Orthopedics, Otolaryngology, Pediatrics, Pharmacy, Oncology

Company Overview

  • Commence delivers AI-driven healthcare data platform and clinical expertise that supports analytics, decisions, and workflow improvement. It was founded in undefined, and is headquartered in Virginia Beach, Virginia, USA, with a workforce of 501-1000 employees. Its website is https://commence.ai.
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