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Specialists needed to assist in developing medical policies

January 31, 2014

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AmeriHealth is currently recruiting physicians from a number of medical specialties to provide us with expert clinical input during the development and maintenance of our medical coverage policies. Medical policies are research-based documents that communicate coverage of medical services for our members, including medical devices, injectable and infusible drugs and biologics, and medical and surgical procedures. In addition, medical policies provide guidelines for obtaining benefits and reimbursement in accordance with the member?s benefits plan.

As a consultant, you would be responsible for evaluating and providing feedback on the scientific evidence and local standards of care addressed in our medical policies. You would evaluate proposed medical policies based on your areas of expertise and be paid a consulting fee. Your contributions could significantly impact the medical policies that AmeriHealth establishes, which in turn affect the delivery of health care in our region.

At this time, AmeriHealth is seeking physician consultants in the following specialties:

  • medical oncology
  • ophthalmology
  • orthopedic surgery
  • pain management
  • radiation oncology

Qualifications

To qualify as a consultant, you must:

  • maintain board certification in each specialty for which you wish to consult;
  • maintain an active clinical practice in each specialty for which you wish to consult;
  • understand and agree to our conflict of interest statement, which is available upon request prior to participation and is reviewed and reaffirmed annually;
  • understand and agree to our confidentiality statement;
  • maintain a high ethical standard, evidenced by the absence of any Amerihealth investigation into personal or group claims practices.

Become a consultant

If you meet these criteria and are interested in sharing your expertise as a consultant, please submit your curriculum vitae by email to AHMedicalPolicy@amerihealth.com or by mail to:

George S. Fenimore, DNP, RN
Director, Medical & Claim Payment Policy
AmeriHealth
1901 Market Street, 29th floor
Philadelphia, PA 19103

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