Collaborative Physician (MD or DO) - Chart Reviewer

Overview

ComplexCare Solutions delivers home assessment services for health plans nationwide utilizing Nurse Practitioners and Physician Assistants.

Many of our NP or PA employees require a collaborative agreement with a physician in order to complete their home assessments based on specific state requirements. The MD collaborator works with these individuals to provide oversight in alignment with state specific requirements, as outlined below. This is a remote position.

Qualifications

• MD or DO with unrestricted license in the State where providers perform assessments
• Board certification in family practice, general practice, internal medicine or geriatrics preferred
• Strong clinical background in evaluation and management of chronic diseases commonly seen in the Medicare and/or Medicaid population
• Computer skills in the Microsoft Suite software programs and Adobe
• Meticulous organizational skills and the ability to manage and meet deadlines
• Strong communication skills and ability to communicate professionally via email communication
• Professionally skilled in personal presentation, verbal, and written communication; and
• Ability to work independently in a self-directed mode

Responsibilities

• Enter into Written Collaborative Practice Agreements and/or a Collaborate Relationship with the CCS Practitioners, depending on state specific requirements;
• Provide supervision and collaborative oversight for CCS Practitioners who provide CCS Practitioner Services in the Service Area, consistent with the Collaborative Practice Agreements and any applicable Protocols, and in accordance with applicable state and federal law;
• Review a representative sample of CCS Practitioner Service records at least once every three months, or more often as required by law or by CCS, to evaluate whether the CCS Practitioner Services were provided congruent with applicable Protocols; provide results of such review to CCS and the applicable CCS Practitioner; and maintain copies on site for possible regulatory agency review;
• Be available to the CCS Practitioner for consultation, as needed, either on site or by electronic access, including but not limited to, telephone, facsimile and email, during normal business hours;
• Attend trainings and orientations arranged and required by CCS, if applicable, such events not to exceed once per month, and be available to participate in conference calls with CCS's Medical Director as may be requested from time to time;
• Maintain such records and furnish such reports regarding provision of the CCS Practitioner Services, including monthly time records appropriately describing the Services rendered, in the form and at such times as required by CCS
• Maintain compliance with Inovalon's policies, procedures and mission statement;
• Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon's Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position;
• Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company;
• Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function;
• We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such.