Family Medicine, Independent Medical Reviewer roles available for Family Medicine

Job Description

\n

Maximus is currently seeking a BC   Family Practice MD/DO as a Medical Expert Reviewer, supporting the  California Department of Managed Health Care (DMHC) Medical Survey . This is a consulting opportunity with travel required three times a year. 

\n

 

\n

Project Overview:

\n

The CA-DMHC Medical Survey conducts routine (every three years), follow-up, and non-routine surveys of licensed managed health care plans. The goal is to ensure compliance with state regulations and confirm that consumers have access to high-quality healthcare services. DMHC oversees commercial and select Medi-Cal managed care plans.

\n

Scope of Work:

\n

Surveyors will function as independent consultants and complete surveys in three phases:

\n

\n
• Pre-Onsite (Remote):
\n
• Review plan documents
\n
• Complete Technical Assistance Guides (TAGs)
\n
• Conduct file reviews using File Review Worksheets (FRWs)
\n
• Prepare for onsite interviews
\n
• Participate in at least one pre-onsite meeting
\n
• Onsite (Travel Required 35 days):
\n
• Conduct interviews
\n
• Perform additional document reviews
\n
• Post-Onsite (Remote):
\n
• Document findings
\n
• Complete survey reports and required documentation
\n

\n

Training:

\n

\n
• Approximately 20 hours of self-paced review of materials
\n
• Shadowing 12 surveys (~12 hours each)
\n
• Fully remote and paid
\n

\n

Level of Effort:

\n

\n
• ~100 hours over a 2.5-month period per survey
\n
• Flexible, part-time consulting engagement
\n

\n

Compensation:

\n

\n
• $145$200/hour (MD/DO)
\n

\n

If youre interested in learning more, Id love to connect and discuss details with you.

\n

Please send your updated CV to View email address on ziprecruiter.com  

\n