Healthcare - Medical Director

Metaintro, Inc.; Florida; Remote; USD 207,000 - 234,000; Part time

Job summary

Molina is hiring a 1099 Behavioral Health Physician (MD/DO) to provide non-clinical utilization management services for behavioral health. The role requires at least 20 hours of availability, is remote, and involves initial and concurrent medical necessity reviews, peer-to-peer reviews, and first- and second-level appeals with documentation and quality improvement participation.

Compensation includes $50-$57 per case for utilization management and $150-$170 per hour for mandatory trainings and

Qualifications

• Board-certified Psychiatry physician required.
• Active unrestricted medical license in applicable state(s).
• Behavioral health utilization management experience preferred.

Responsibilities

• Provide non-clinical utilization management services for behavioral health.
• Conduct initial and concurrent medical necessity reviews.
• Perform peer-to-peer reviews and contribute to first- and second-level appeals.

Skills

Medical necessity

Peer-to-peer reviews

Appeals

MHPAEA

NCQA/CMS

HIPAA

Education

MD/DO with Psychiatry board certification

Job description

- /Healthcare - Medical Director# Healthcare - Medical Director at MolinaCompensation$50 - $170Location: Florida · Ohio## DescriptionMolina is hiring a 1099 Behavioral Health Physician (MD/DO) to provide non-clinical utilization management services for behavioral health services. The role includes initial and concurrent medical necessity reviews, peer-to-peer reviews, and first- and second-level appeals, with documentation, quality improvement participation, and compliance with federal, state, MHPAEA, NCQA, and CMS requirements. The physician must have board certification in Psychiatry, an active unrestricted medical license in the applicable state(s), and behavioral health utilization management experience; the position is remote, requires at least 20 hours of availability, and pays $50-$57 per case for UM and $150-$170 per hour for mandatory trainings and meetings.## Required Skills* Medical necessity* Peer-to-peer reviews* Appeals* MHPAEA* NCQA/CMS* HIPAAMinimum Education: MD or DO with board certification in PsychiatryRequired Previous Experiences: Behavioral health utilization management experiencePreferred Qualifications: Managed care or health plan experienceFor job seekersUpload your résumé, start a Job Search Thread, and let Metaintro rank real openings against your experience - then guide you from search to offer.PositionTurn proof projects into role-specific applications.