Psychiatrist Physician Reviewer
New
Remote within the state of IllinoisContract
Salary70.97 - 125 USD per hour
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Job Details
- Required Skills
- Microsoft ExcelPowerPoint
Requirements
- Licensed Physician (MD/DO) to practice in all branches in Illinois
- Board Certification in Psychiatry
- Engaged in active practice
- Have admitting or staff privileges in one or more Illinois hospitals or state facilities
- Experience in Utilization Management, Case and Disease Management with knowledge of Medicaid and Medicare program
- Knowledge of standards of practice related to the determination of level of care
- Knowledge of Medicaid programs with relevant experience navigating similar complex projects
- Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook
Responsibilities
- Conduct peer-to-peer physician consultations as requested/required and document consultations
- Provide clinical expertise with respect to planning and establishing goals and policies to improve clinical operations
- Represent the organization through state appeal processes
- Review medical information trends, experiences, and approaches and assist in the development of strategic plans for clinical improvements
- Provide program representation at stakeholder engagement meetings
- Ensure compliance with regulatory and accreditation requirements
- Analyze and remain current on national, state, and local regulations and legislation which impact the healthcare profession
- Represent and promote Acentra Health at seminars, professional societies, medical staff meetings, and other professional settings as appropriate
- Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
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