Job description

Position:

Medical Case Reviewers

Job Classification:

Analyst

Location:

Remote (possible travel based on case)

Duration:

Permanent

Start Date:

Contract beginning Oct - Nov 2022 (estimate, not guarantee)

FLSA Status:

Non-exempt. N/A if on contractor agreement

Position Type:

Independent Contractor, paid hourly

General Description:

J29 is a healthcare management company with significant clinical expertise in Medicare and Medicaid data, a history of clinical review on all parts of Medicare, and demonstrated experience in leveraging innovative technologies to improve the quality of our medical claims review. Established in 2017, J29 prides itself on its employee centric culture and high employee retention rates. Our team brings corporate performance that stretches to various areas of CMS, such as the Office of Financial Management (OFM), the Center for Medicare (CM), and the Center for Clinical Standards and Quality.

In support of the Health Resources and Services Administration (HRSA), an agency under the Department of Health and Human Services, J29 is anticipating working on the Vaccine Injury Compensation Program (VICP) and Countermeasure Injury Compensation Program (CICP). These two Federal programs are set-up provide compensation to people found to be injured by certain vaccines or countermeasures, following medical record review of their claim. We are looking for Medical Reviewers to assist us in the review process and ultimately help us make determinations on these claims:

Duties:

• Obtain and review the case file, which includes the petition, medical records, affidavits, depositions, exhibits, and other relevant documentation for determining;
• Adequacy of available information, likelihood of vaccine causation based on medical principles, knowledge of the literature and
• An understanding of associated disease and conditions

• Consult on the case with the assigned program personnel (J29 or HRSA experts, and Office of General Counsel (OGC) Attorney and/or the Department of Justice (DOJ) attorney)
• Work to notify the applicable support staff of the need for additional requests for information in the medical record file
• Provide an initial written draft, and eventual final report to the Team Lead and DOJ attorney by the due date provided in the Case Review Guidance Memo sent with case file. The report shall;
• Identify the essential points in question
• Provide determination of eligibility for compensation based on the Countermeasure Injury Table in Statute
• Provide determination of preponderance of evidence to support a “factor unrelated” or alternate cause and make recommendations in medical reports
• Obtain outside medical consultation and interpretation in context of Statute in specific case review and provide the expert’s opinion
• Consult with the Team Lead and attorneys in preparation of reports for legal proceedings by the due date provided in the Case Review Guidance Memo.

• Participate in-group panel discussions on case findings in order to reach consensus on proceedings of case
• Abide by J29 and HRSA’s strict information technology policies on the handling of Protected Health Information (PHI), and other requirements for the handling of protected patient data
• Work with J29, HRSA, and other J29 partners, should further consultation be needed on a case due to complexity
• Ensure that all medical record review is done in a quality manner, while also meeting the timeliness goals.

General Experience:

• Possess the experience and skill to independently diagnose condition(s) after extensive review of medical records
• Possess the skill to review available credible scientific and medical literature and make decisions regarding whether a vaccine or countermeasure caused an injury/death
• Possess 2 years or more of experience with independent medical diagnosis after medical record review

Education Requirement:

• MD (Doctor of Medicine) or DO (Doctor of Osteopathy):
• Possess a Doctor of Medicine or Doctor of Osteopathy from a medical school in the United States, the District of Columbia, the Commonwealth of Puerto Rico, or other territory of the United States or an equivalent degree from a foreign medical or osteopathic school that provides education and medical knowledge equivalent to accredited schools in the United States.
• Possess a current, active, full, and unrestricted license or registration as a physician from a state within the United States, the District of Columbia, the Commonwealth of Puerto Rico, or other territory of the United States.

OR

• PhD (Doctor of Philosophy):
• Possess an advanced degree acquired from the list of postsecondary institutions that are accredited by accrediting agencies or an equivalent degree from a foreign postsecondary institution that provides education equivalent to accredited schools in the United States.
• If primarily in clinical practice (defined as "involving activities with and on behalf of patients"), offeror should be currently in clinical practice or have left clinical practice in a period not more than 5 years prior to application.

OR

• Other Advanced Medical Professional Degree:
• Physician Assistant, Registered Nurse; Nurse Anesthetist, Nurse Practitioner, Clinical Nurse Specialist, Physical Therapist and Physical Therapy Assistant.

J29, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, sex, sexual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. J29, Inc. is a proud Veteran friendly employer.

Job Type: Contract

Benefits:

• Flexible schedule

Medical specialties:

• Cardiology
• Critical & Intensive Care
• Emergency Medicine
• Home Health
• Medical-Surgical
• Primary Care
• Psychiatry
• Surgery

Schedule:

• Self-determined schedule

Application Question(s):

• Do you have an understanding that this is a contract position where the work amount is determined on the amount of cases to review?

Education:

• Bachelor's (Required)

Experience:

• medical diagnosis: 2 years (Required)

License/Certification:

• MD, DO, PHD, or Med Degree (PA, RN, NA, NP, CNS, PT, PTA)? (Required)

Work Location: Remote

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