Physician Consultant – Independent Contractor


Physician Consultant – Independent Contractor



Who we are:

Constellation Quality Health is a non-profit health care quality consultancy and QIO-like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina’s Research Triangle, we contract with the North Carolina Department of Health & Human Services to conduct prior authorization reviews for Medicaid beneficiaries. The purpose of the reviews is to determine if the beneficiary’s medical condition and needs justify the frequency and intensity of outpatient services requested (physical, occupational, and speech-language therapies).


What you’ll do:

The Physician Consultant participates in telephone consultations and renders decisions about the medical necessity of requested services. The time commitment for this role is on average approximately 15 minutes per week, noting that there may be weeks when no consultation is needed.


We expect you to:

  • Review written case summaries in advance of scheduled consultation times during normal business hours.
  • Discuss cases with the reviewing therapists.
  • Assist in defending any adverse determinations which are appealed.



Our requirements for this role:

  • NC Licensure (no sanctions)
  • Board Certification in one of the following:
    • Orthopedic Surgery – a subspecialty in Sports Medicine is preferred.
    • Physical Medicine and Rehabilitation – a subspecialty in Neuromuscular, Sports, Brain Injury, or Pain Medicine is preferred.
    • Pediatrics – a subspecialty in Developmental-Behavioral Pediatrics is preferred.
  • Minimum 5 years experience
  • Actively practicing



Why Constellation Quality Health:

  • We offer a competitive salary and benefits package and a flexible work environment.
  • Equal opportunity employer of protected veterans.
  • Equal opportunity employer of individuals with disabilities.
  • We do not discriminate on the basis of race, ancestry, color, religion, sex, age, marital status, sexual orientation, gender identity, national origin, medical condition, disability, veteran status, or any other basis protected by law.
  • Applicants and employees are protected from discrimination based on inquiring about, disclosing, or discussing compensation or the compensation of other applicants or employees.