Pediatrician (Part-Time) - California

Gainwell Technologies LLC

8d•$115,000 - $129,000•Hybrid

About The Position

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. SummaryBoard-certified or board-eligible physician specializing in pediatrics with three or more years of direct patient care experience to perform online reviews of medical documentation requiring the clinical expertise of a pediatric general practitioner. In this role at Gainwell, you will contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve—particularly in communities most vulnerable—while working alongside teams focused on innovative, purpose-driven solutions. Your role in our mission This position is a part-time (20 hours), contractual-required role for the Medi-Cal MMIS account for the Department of Health Care Services (DHCS). As a member of the Medical Review team, you will use your clinical knowledge and acumen to respond to medical claims, referrals, and inquiries from DHCS that require the expertise of a qualified pediatrician with a strong clinical background.

Requirements

Minimum of three (3) years of clinical experience as a pediatrician
A current California medical license
Strong communication skills, as well as strong interpersonal and analytical skills
Must reside within 35 miles of the Sacramento State Capitol, California
Comfortable using the following applications: Word, Excel, and Outlook

Responsibilities

Responding to referrals from DHCS within four (4) hours of notification
Reviewing policy and attending meetings with DHCS
Processing suspended claims requiring expertise from a medical specialist and responding to referrals from internal departments
Expected to cross-train to help provide coverage for other consultants when required