The Physician Consultant assists with the scoring of Florida Health Plan Program applications within Care Management on an ad hoc basis. The Physician Consultant serves as an expert in the content and interpretation of the health plan accreditation program and standards. Primary responsibilities include conducting/assisting staff in analyzing accreditation application documentation and conducting validation reviews. The Physician Consultant will participate in Virtual Reviews (VRs) onsite and virtually.

The Physician Consultant will perform the following activities:

1. Serve as the Physician Reviewer experienced in health maintenance organizations (HMO) quality assurance program management activities.
2. Participate in the Desk Top Review (DTR) of assigned applications to include:

• Reviewing application materials to determine compliance with the standards under review
• Providing input to the Lead Reviewer regarding Applicant's compliance to program standards for inclusion i n RFI as needed.
• Reviewing additional information submitted by the Applicant to determine the organization's preparedness for a Validation Review.
• Providing documentation of all findings and recommendations to Lead Reviewer.

Education and training requirements:

• Physician experienced in Health Maintenance Organization quality assurance program management.

Licensure/Board Certification Requirements:

• A current Board-Certified license as a physician within the United States.