Independent Physician Reviewer Job at RediMinds

Senior Physician, Patient Safety

Join our dynamic Patient Safety team as a Senior Physician where you'll leverage...

Location

United States; Canada , Remote; Alberta

Salary:

Not provided

Parexel

Expiration Date

Until further notice

Requirements

Experience in clinical medicine (general or specialist qualifications) which is expected to be kept up to date
Good knowledge of drug safety and the drug development process
Good knowledge/understanding of medical terminology
Relevant experience in pharmacovigilance/ Drug Safety/ Clinical Practice
3 - 5 years previous experience in pharmacovigilance and/or medical monitoring is required
US Board Certification/board eligibility or regional equivalent for Canada
Bachelor of Medicine, Bachelor of Surgery (MBBS) / Doctor of Medicine (MD)/ Medically qualified from an acknowledged Medical School
Completion of at least basic training in clinical medicine (residency, internship etc.)
Demonstrated success in technical proficiency and scientific creativity
Good presentation and verbal/written communication skills

Job Responsibility

Maintaining a good working knowledge of the Adverse event/Safety profile of assigned products, labeling documents, data handling conventions, client’s guidelines and procedures, and global drug safety regulations and guidelines
Maintaining an awareness of global regulatory requirements, reporting obligations and organizing workload to ensure compliance with internal and regulatory timelines for adverse event reporting
Performing medical review of cases not limited to (including complex and challenging cases requiring expert judgement)), clinical trial, and literature cases including combination products {drug-device}) according to client/Parexel Standard Operating Procedures (SOPs
as applicable) and liaising with the client, as require
Writing Pharmacovigilance/Marketing Authorization Holder (MAH) comment and assessing company causality
Review appropriateness of medical content in narrative for medical coherence
Assessing seriousness, listedness / expectedness of reported events
Providing medical inputs to case processing team
Raising appropriate follow-up queries for relevant information from the reporter/HCP (Health Care Professional)
Review and verify appropriate selection of adverse events from source documents, assign appropriate Medical Dictionary for Regulatory Activities (MedDRA) code, review narrative

What we offer

Flexible approach to work that meets your personal needs
Work from home
Benefits vary by country
Investment in your professional and personal development

Associate Director, Value Assessment – Independent Physician Associations Vaccines- US WEST

Join the team protecting half a billion lives every year with next-gen science, ...

Location

United States , Remote

Salary:

148500.00 - 214500.00 USD / Year

Sanofi

Expiration Date

Until further notice

Requirements

Bachelor's degree required
5+ years of experience in market access, payer engagement, or health economics related function (Vaccines a plus)
Must have experience navigating health systems and Independent Physician Associations or other risk-bearing entities
Vast understanding of commercial payer reimbursement and risk-barring methodology
Financial experience, vaccines understanding
Strong understanding of financial analysis/economic modeling
Attention to building and maintaining customer relationships to achieve success
Demonstrates Executive Presence in all types of interactions, boardrooms, in-person & remote
Collaborates across functional, geographic, and company boundaries to meet mutual business objectives
Continually focuses on the performance and development of oneself and others to enhance the talent of the company

Job Responsibility

Engage with C-suite level decision makers across Risk-based organizations (RBO) and Independent Physician Associations the use of Sanofi portfolio
Maximize the understanding of the economic value of Sanofi Vaccines products and demonstrate the clinical and economic value to customers in a compelling way according to their financial, quality and clinical objectives
Develop and update targeting and profiling in the assigned geography
Identify the optimal IPAs and RBOs with the highest probability of success of engagement
Map key decision makers within the IPAs and RBOs, noting any overlaps with other Sanofi customers or providers
Continuously assess trends in risk-based contracting and alternative payment models that influence opportunities within IPAs and similar entities
Identify strategy and tactics to payers when appropriate
Develop engagement strategy and tactics based on sound rational using available data sources, the collective intelligence of cross-functional teams and learnings from external sources
Document and share insights from IPA and RBO engagements to help inform Sanofi’s broader Market Access strategy
Contribute to refining the value proposition for the different types of RBOs, including IPAs, shifting conversations from cost only to health economics analysis, models, budget impact models, reimbursement arguments and clinical efficacy

What we offer

Company car through the Company’s FLEET program
Wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs
At least 14 weeks’ gender-neutral parental leave

Fulltime

Physician Coding Review Specialist

Location

United States

Salary:

26.55 - 39.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA)
Coding Specialist - Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA)
Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA)
Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC)
Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC)
Specialty Medical Coding Certification issued by the American Academy of Professional Coders (AAPC)
Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist
Typically requires 5 years of experience in expert-level professional coding and at least 3 years of experience in the education of clinicians in physician revenue cycle processes, health information workflows, and medical record auditing experience
Advanced knowledge of ICD, CPT, and HCPCS coding guidelines

Job Responsibility

Review assigned codes, which most accurately describe each documented diagnosis and/ or procedure according to established CPT, HCPCS, and ICD-10-CM coding guidelines along with modifier usage and medical terminology
Monitor all coding accuracy at various levels of detail and maintain coding quality as needed
Track coding issues and review coding inaccuracies to highlight areas of improvement
Report or resolve escalated issues as necessary
Responsible for reviewing Clinician documentation and billed codes for Medical Group physicians and non-physician clinicians
Review of medical records in collaboration with key stakeholders such as Internal Audit, Compliance, and Clinic Operations
Responsible for completing all certified coder quality reviews
Working in collaboration with Coding Production Leads and Supervisors
Follows the prospective and/or retrospective review plan to sample employed Clinician's medical record documentation in comparison to services selected for billing, based on best practice methodologies which will be presented and reviewed with Clinicians to provide feedback on proper coding and documentation practices
Follows the necessary schedules for team assignments of documentation/coding accuracy

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

New

Independent Physician Reviewer – Medical Oncology, Surgical Oncology or Radiation Oncology with clinical experience in Breast Cancer Care

RediMinds is building a national panel of physicians to serve as independent cli...

Location

United States

Salary:

Not provided

RediMinds

Expiration Date

Until further notice

Requirements

Board Certified (ABMS or AOA)
≥5 years post-training experience, with direct patient care in the last 12 months
Active medical license (multi-state preferred)
Strong research and writing skills
comfort with deadlines and objective, evidence-based decision-making
Reliable home office setup, secure internet, and familiarity with independent contracting (1099)
Comfort using modern, secure software tools
willingness to learn AI-assisted workflows

Job Responsibility

Review case files and medical necessity criteria, apply current standards of care, and render objective determinations
Cite supporting guidelines and literature (our platform helps you quickly surface and trace sources)
Draft clear, concise rationales and communicate determinations within defined timelines
Collaborate with our team by sharing workflow feedback to continually improve reviewer experience

What we offer

Flexibility: Review cases remotely and choose your caseload
Impact: Influence medical coverage decisions for patients, providers, and payers
Future-ready tools: Work with a state-of-the-art, AI-assisted review platform that synthesizes arguments, surfaces current standards of care, and compiles recent literature—so you focus on clinical judgment, not paperwork
Co-create the product: Provide structured feedback that directly shapes features used by reviewers like you
Professional development: Training, resources, and optional peer collaboration to sharpen reviewer skills
Competitive rates: Predictable, competitive case-based honoraria with fast, reliable payment

Behavioral Health Medical Director

The Behavioral Health Medical Administrator (Medical Director) directs, leads, a...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

3 years of experience in a clinical setting
1 year of experience in physician leadership role, including quality review, utilization review, population health and other managed care functions
Medical Degree
Active, current, and unrestricted license to practice medicine in the State of Arizona (a state in the United States)
Board Certification in general psychiatry, or adult and child/adolescent psychiatry, through the American Board of Psychiatry and Neurology
Requires knowledge and skills in state (Arizona) and federal behavioral health regulations, requirements for publicly funded services, delivery, operations, and licensure.
Knowledge of managed care concepts and practices
and emerging and best practices for adult & children’s integrated care programs.
Ability to use electronic word processing, email, and electronic database resources.
Excellent customer service and oral/written communication skills

Job Responsibility

Directs, leads, and provides professional oversight for medical management and population health activities related to behavioral health utilization management, case and care management, disease management, performance improvement, and quality management activities.
Supports collaborative relationships with physicians and hospitals to achieve mutually acceptable business goals in compliance with AHCCCS and CMS regulations.
Provides physician leadership and medical oversight in the design, implementation and review of clinical services, best practices, care management, medical management and quality management.
Serves as liaison between the Medicaid Business Segment and medical and behavioral health practitioners at stakeholder and provider agencies.
Participates in aggregate and member-level clinical analyses for quality management, quality of care concerns, peer review, medical management, and utilization review processes.
Reviews and authorizes requests by providers and treatment coordinators for services or programs requiring prior authorization.
Participates in the design and implementation of best practices, clinical standards, protocols, and treatment guidelines.
Participates in credentialing, re-credentialing and competency processes for providers.
Assists care managers with care management of high risk/high-cost members.
Participates as a member or chair of internal and external committees.

Parttime

Cardiac Device Specialist

Location

United States , Naperville; Aurora

Salary:

28.55 - 42.85 USD / Hour

Advocate Aurora Health

Expiration Date

Until further notice

Requirements

High School diploma
Bachelor’s degree encouraged/preferred
3-5 years clinical cardiovascular experience
Familiar with cardiac devices, such as pacemakers and automatic internal cardiac defibrillator systems
Good computer and organizational skills
Good communication skills
Ability to identify cardiac arrhythmias and abnormalities in devices
Willing to learn pacemaker and defibrillator analysis
Ability to assess, plan and intervene and evaluate the physical, emotional and education needs of patients
Current CPR certification

Job Responsibility

Responsible for contacting patients in regards to any company recalls thus requiring closer and more frequent monitoring and taking appropriate measures for any further changes in the device that may be required
Is knowledgeable of assisting with job duties of all personnel in the department
Evaluates, manages and provides support in the delivery of quality clinical care of patients with cardiac pacemakers and automatic internal cardiac defibrillator systems
Performs an independent daily review of remote transmission of the devices implanted within patients
Responsible for performing interrogations and necessary reprogramming of devices in patients who are scheduled in the office setting, including urgent walk-in appointments
Able to interpret arrhythmias, troubleshoot and reprogram settings of pacemaker / defibrillator according to patient’s needs and department protocols
Consistently encourage questions from patients and their families and offers guidance that fosters compliance
Provides patient education on all aspects of heart pacing
Maintains the computer programmers for patient interrogations
Work with the patient to ensure that all clinical and remote device check data reports are completed and entered into the device data base

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Nurse Practitioner

A physician assistant is defined as a person who is a graduate of a school appro...

Location

United States , Weymouth

Salary:

107000.00 - 224123.00 USD / Year

South Shore Health

Expiration Date

February 12, 2027

Requirements

Graduate of an AMA recognized Physician Assistant training program accredited by the Accreditation Review Commission or Education for Physician Assistant (ACR-PA)
Must possess a valid license to practice as a Physician Assistant from the Massachusetts Board of Registration for Physician Assistants
Must be certified by the National Commission for the Certification of Physician Assistants
if a recent graduate, must sit for exam and successfully pass it at the next time the examination is offered
For ambulatory, we only require BLS
if in the hospital ACLS is required
This position is a licensed independent practitioner credentialed through the Medical Staff Services Office

Fulltime

Financial Compliance Auditor III

The Specialty Health Plans Auditor III, Finance is responsible all aspects of pl...

Location

United States , Los Angeles

Salary:

Not provided

Bright Vision Technologies

Expiration Date

Until further notice

Requirements

Bachelors Degree in Accounting or Finance
At least 4 years of experience in conducting financial audits
At least 5 years of related experience in the managed health care industry
Excellent analytical and critical thinking skills
Action-oriented, self-starter, and excellent motivator
Excellent verbal and written communication skills
Able to prioritize assignments, and able to independently with minimum supervision
Ability to interface professionally with both internal and external customers at all levels of the organization
Proficiency in Microsoft Office (Excel, PowerPoint, and SharePoint)
Certified Public Accountant (CPA) or Certified Internal Auditor (CIA) or Certified Fraud Examiner (CFE) or Certified Management Accountant (CMA)

Job Responsibility

Performs financial audits and/or financial analyses for Specialty Health Plans on the quarterly and annual basis
Performs financial analyses for L.A. Care vendors on the quarterly and annual basis
Provides timely and accurate deliverables to ensure financial solvency and claims processing compliance with regulatory and contractual requirements for plan partners, participating provider groups, capitated hospitals, specialty health plans, and vendors
Collaborates in the creation and implementation of standardized audit workpaper and reporting templates
Is cross trained on financial solvency reviews for Participating Physician Group (PPGs), PPs, and capitated hospitals
Reviews and updates annually the department’s Policies and Procedures (P&Ps)
Supports the formalization of key internal processes and monitoring tools
Accountable for the completion of requests from Legal Department, Delegation Oversight’s monitoring oversight and reporting
Responsible for the overall communication and collaboration with interdepartmental personnel, leadership, specialty health plans, and vendors
Collaborates on the design, implementation, and reporting of special projects

What we offer

equal employment opportunities
inclusive work environment
accommodations during the recruitment process

Fulltime

Independent Physician Reviewer

RediMinds

Location:
United States

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
February 14, 2026

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