External Physician Reviewer

AFMC is looking to contract with physicians to complete prior authorizations and retrospective reviews. Compensation is paid by review completed. 

Specialists Needed:

• Hematologist/Oncologist
• Pulmonologist
• Neurologist
• Cardiologist
• Gastroenterologist
• Urologist
• Ophthalmologist
• Geneticist
• Hospitalist
• Rheumatologist

Scope of Services:
The types of reviews AFMC Clinical Services completes are Medicaid prior authorizations and retrospective reviews. 

• Perform assigned initial and reconsideration reviews such as:
  • Prior authorizations for:
  • Durable Medical Equipment, Hyperalimentation, Ventilators, and Wheelchairs
  • Medical/Surgical Procedures and Hyperbaric Oxygen Treatment
  • Physician Administered Drugs
  • Molecular Pathology
• Retrospective reviews for:
  • Inpatient Length of Stay
  • Emergency Room
  • Extension of Benefits
  • Hospital Acquired Conditions
  • Acute Crisis Unit
• Use AFMC ReviewPoint – a clinical review platform, when indicated. 
• Maintain reliable internet with speeds of 2Mbps uploaded to maintain call quality and process integrity. 15Mbps download generally allows more fluid access to data and systems while lower speeds will result in increased lag time. Please note there is nothing AFMC team can do to improve your home internet access. To test your speed, go to www.speedtest.net.
• Additional duties, as agreed upon.

Credentialing Qualifications: 

1. Active, unrestricted license to practice medicine in Arkansas
2. Board-certified
3. Minimum of five (5) years full-time equivalent direct patient care experience
4. Direct patient care experience within the previous three (3) years
5. Maintain current liability and malpractice insurance coverage for non-UR clinical activities
6. Located in a state or territory of the United States when conducting appeal considerations

Internet Requirements:
Reliable, high-speed wireless internet service (Wi-Fi)