Independent Consultant - Medical Director, Oncology & Specialized Clinical Review

Physician Consultant - Hematology and Oncology

HealthCare Partners, IPA and HealthCare Partners, MSO together comprise our health care delivery system providing enhanced quality care to our members, providers and health plan partners. Active since 1996, HealthCare Partners (HCP) is the largest physician-owned and led IPA in the Northeast, serving the five boroughs and Long Island. Our network includes over 6,000 primary care physicians and specialists delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. Our MSO employs 200+ skilled professionals dedicated to ensuring members have access to the highest quality of care while efficiently utilizing healthcare resources. HCP's vision is to be recognized by members, providers and payers as the organization that delivers unsurpassed excellence in healthcare to the people of New York and their communities. We pride ourselves on selecting the most qualified candidates who reflect HCP's mission of serving our members by facilitating the delivery of quality care.

Interested in joining our successful Garden City Team? HealthCare Partners (HCP) is seeking an experienced physician consultant with expertise in Hematology and Oncology to provide specialized clinical consulting and medical review services in support of HCP's medical management, utilization management, and quality-of-care initiatives. This is an independent contractor consulting engagement, not a full-time or part-time employee position. Services will generally be performed remotely and on an as-needed basis, based on HCP's clinical review and consultation needs. The volume and complexity of assignments may vary.

Consulting Services The Consultant will provide physician-level clinical expertise and independent professional judgment in connection with complex oncology, hematology, and other specialized clinical cases. Consulting services may include, but are not limited to:

• Reviewing oncology and hematology-related authorization requests, including chemotherapy, radiation oncology, advanced or specialized treatments, and other complex services.
• Reviewing requests involving genetic testing, molecular/genomic testing, targeted therapies, and other specialized diagnostic or treatment services.
• Providing clinical consultation regarding clinical trials, investigational therapies, emerging treatments, and other complex or specialty cases.
• Conducting peer-to-peer consultations with treating physicians and specialists to discuss clinical circumstances, treatment plans, and available treatment alternatives.
• Providing specialized clinical guidance to HCP medical management physicians, nurses, and other designated clinical personnel regarding complex oncology and hematology cases.
• Reviewing clinical documentation and medical records to assist with determinations regarding medical necessity, appropriateness, and clinical rationale for requested services.
• Providing retrospective clinical consultation to support quality, utilization, and appropriateness-of-care reviews.
• Advising HCP regarding evidence-based oncology and hematology practices, clinical standards, and applicable regulatory or industry guidelines.
• Providing input regarding the development or refinement of clinical guidelines, review criteria, and processes applicable to oncology, hematology, genetic testing, clinical trials, and other specialized services.
• Communicating with HCP staff and treating providers, as reasonably necessary, to clarify clinical information, discuss cases, and support appropriate clinical decision-making.

The Consultant will interface with designated HCP professional and administrative staff as necessary to perform the consulting services and will exercise independent professional judgment in providing clinical opinions and recommendations.

Engagement Structure

• Independent contractor/consulting engagement
• Remote
• As-needed/flexible schedule
• Work volume will vary based on HCP's clinical review and consultation needs
• Compensation will be based on approved consulting activities and services actually performed
• This engagement does not constitute employment with HealthCare Partners

Qualifications The ideal consultant will have:

• MD or DO degree and active, unrestricted medical licensure applicable to the services provided.
• Board certification in Hematology, Medical Oncology, or Hematology/Oncology.
• Significant clinical experience in the evaluation and management of oncology and hematology patients.
• Experience with complex medical decision-making, utilization management, medical necessity review, or health plan/managed care clinical review preferred.
• Familiarity with evidence-based oncology guidelines, treatment standards, specialty pharmaceuticals, genetic and molecular testing, and emerging therapies.
• Experience conducting physician-to-physician or peer-to-peer consultations preferred.
• Strong clinical judgment and the ability to independently evaluate complex medical records and clinical documentation.
• Strong written and verbal communication skills.

Consulting Compensation Approved consulting services will be compensated as follows:

• Clinical consulting/review services: $125 per hour, with a 30-minute minimum.
• Peer-to-peer consultations: $150 per completed consultation.
• Denial statements/clinical rationale: $75 per completed statement, with a 30-minute minimum where applicable.

About the Engagement This opportunity is intended for an experienced physician who is interested in providing specialized oncology and hematology expertise on a flexible consulting basis without the commitment of a traditional employment arrangement. The Consultant will be responsible for maintaining all professional credentials, licenses, certifications, and other qualifications necessary to perform the services and will provide services consistent with applicable professional standards, HCP policies and procedures, and applicable regulatory and clinical guidelines. Interested physicians are invited to submit a CV/resume outlining their clinical background, oncology/hematology experience, and relevant managed care or utilization review experience.

Equal Employment Opportunity Statement: HealthCare Partners, MSO is committed to fostering a diverse and inclusive workplace. We provide equal employment opportunities (EEO) to all employees and applicants without regard to race, color, religion, sex, national origin, age, disability, genetics, or any other protected status under federal, state, or local laws. In compliance with all applicable laws, HealthCare Partners, MSO upholds a strict non-discrimination policy in every location where we operate. This policy applies to all aspects of employment, including but not limited to recruitment, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Job Disclaimer: The above job description outlines the general scope and responsibilities of the position. It is not intended to be an exhaustive list of duties, skills, or qualifications required. Responsibilities may evolve based on business needs.