PRN Ophthalmologist (Remote)

STGi is currently seeking an Ophthalmologist - Reviewing Medical Officer (RMO) for the Law Enforcement and Surveillance Case Review Program for Federal Occupational Health Services (FOH) in Rockville, MD.

Job Specific Duties and Responsibilities: Provide medical consultation and case review evaluations on Workers’ Compensation cases, primarily for the Department of Labor (DOL) on Federal Employee Compensation Act cases.

The Joint Commission – Quality and Safety

• Completes training on DFEC policy, procedures, and regulations prior to performing case reviews.
• Performs medical consultation in accordance with FOH’s policy and standard operating procedures.

Service Operations

• Supports the medical and consultative needs for the Department of Labor (DOL) and other federal agency workers’ compensation programs when requested.
• Evaluates workers’ compensation case files, interprets medical reports, evaluates medical evidence and test results, translates technical medical language, and provides guidance or instruction to customer agencies regarding general medical issues that pertain to workers’ compensation cases.
• Performs DOL FECA case reviews in accordance with DOL FECA regulations. The type of case reviews include:
• Medical/Surgical Review – Routine: This category will cover review for routine medical/surgical authorization or opinion on issues including, but not limited to, extended physical therapy, consequential condition causal relationship, etc. Provides a written medical opinion for medical/surgical review cases within 10 business days of receipt.
• Medical/Surgical Review – Complex: This category will cover review for medical/surgical authorization or opinion on complex issues including, but not limited to, destructive procedures, and complex medical conditions (cardio pulmonary, psychiatric, etc.). Provides written medical opinion response for this case type within 20 business days of receipt.
• Impairment Rating (Routine and Complex): Provides medical consultation on impairment ratings for cases involving orthopedic issues, musculoskeletal injuries, and organ dysfunction. Impairment rating evaluations are conducted in accordance with the AMA Guides to the Evaluation of Permanent Impairment (6th edition). Provides a written opinion for impairment rating case reviews within 10 or 20 business days of receipt for simple and complex cases, respectively.
• Death Claim Review: Evaluate medical information in death claims for causal relationship. Provides a written opinion for this case type within 10 business days of receipt.
• Expedited Review – Performs reviews on catastrophic injury cases or other instances in which an expedited response is required in order to approve care. Provide written medical opinions for this case type within 3 business days of receipt.
• Demonstrates a strong level of technical expertise in performing medical consultation for workers’ compensation cases and an ability to work and communicate orally and in writing. Renders medical opinions with a reasonable degree of medical certainty and provides clear written rationale for these medical opinions.
• Possesses a strong technical knowledge regarding federal safety and health and workers’ compensation regulations.
• Demonstrates a high level of professional conduct.
• Provides expert medical advice and consultation to FOH and its federal customer agencies on worker’s compensation issues.
• Provides expert consultation as subject matter expert for FOH Reviewing Medical Officers and FOH federal agency customers for the specialty designated on the privilege dispensation form.

Clinical

• May be required to conduct hands-on examinations (if so privileged by FOH), render a professional opinion as it relates to work clearances or recommendations consistent with the examination findings and established physical qualifications.

Procurement

• Submit monthly billing in the specified format and by specified deadlines.

Staffing and Reporting Relationships

• Receives program direction from the FOH Medical Director.

Technology

• Complies with DFEC program requirements regarding access to and use of DOL databases or applications that contain confidential medical and personal information.