Psychiatrist-Physician Reviewer

Fortuna BMC; Nevada; Remote; USD 200,000 - 250,000; Part time

Job summary

Fortuna BMC is seeking a Board-Certified Psychiatrist for a part-time remote position in Nevada. The role includes conducting electronic case reviews for prior authorizations, ensuring compliance with medical guidelines, and engaging in peer discussions and Fair Hearings. This flexible opportunity specializes in administrative roles without direct patient care, offering support and collaboration among a dedicated team.

Benefits

Flexible schedule

Professional support from peer physicians

Paid sick leave

Medical, dental, and vision benefits

Free TeleMedicine for employees and families

Qualifications

• Must reside within the state of Nevada.
• Experience with electronic medical review systems is preferred.

Responsibilities

• Review prior authorization requests electronically.
• Participate in peer-to-peer reviews.
• Engage in Fair Hearings as needed.

Skills

Strong clinical decision-making

Analytical skills

Effective communication

Education

Board-certified Psychiatrist (MD or DO)

Unrestricted U.S. medical license

Tools

Electronic medical review systems

Job description

Join our team as a Board-Certified Psychiatrist (MD or DO) with an unrestricted U.S. medical license, where you will play a key role in prior authorization reviews for medical services. This position involves assessing medical necessity through electronic case reviews and ensuring adherence to clinical guidelines and best practices.

As a part-time, contract-only role, this opportunity offers flexibility and professional collaboration, with responsibilities that include peer-to-peer reviews and participation in Fair Hearings as needed.

Work Site: Remote- Must be physically located in Nevada.

Work Schedule: Part-Time: Estimated 10-15 hours per week, with potential increases when covering for other physicians on leave.

Compensation: $120.00 Per Hour

Contract Length: 2025-07-01 to 2026-06-30

What We Offer:

• Flexible schedule with remote work opportunities.

• Professional support from a dedicated Medical Director and a team of peer physicians.

• No direct patient care - all work is conducted electronically.

• Paid sick leave based on state regulations after 90 days of employment

• Medical, dental, and vision are offered after a waiting period (60% paid by Fortuna)

• Free TeleMedicine and Mental Health for all employees and their families

• Additional volunteer options such as Group Life Insurance, Accidental Insurance, Critical Care, Short Term Disability

What You'll Do:

• Review prior authorization requests electronically to assess medical necessity.

• Make clinical determinations based on medical guidelines and best practices.

• Participate in peer-to-peer reviews when a prior authorization is denied and providers request further discussion.

• Engage in Fair Hearings if a negative action is appealed, explaining the review process and decision-making rationale.

• Collaborate with the Medical Director and physician team to ensure consistency and compliance in medical reviews.

What You'll Bring:

• Board-certified Psychiatrist (MD or DO).

• Unrestricted U.S. medical license (active and in good standing).

• Must reside within the state of Nevada, United States.

• Strong clinical decision-making and analytical skills.

• Experience with electronic medical review systems is preferred.

• Ability to communicate medical decisions effectively, especially in peer-to-peer and Fair Hearing settings.

About Fortuna

Fortuna is a staffing agency dedicated to connecting top talent with employment opportunities. Founded in 2012 by professionals with over 50 years of combined experience, we specialize in sourcing, screening, and presenting candidates for various industries.

Our headquarters is located in McClellan, California, with additional offices in Los Angeles, New York, the Philippines, and Israel. Fortuna is an active member of multiple California service agreements, including:

• CMAS

• ITMSA (Tier 2)

• CalPERS SpringFed Pool

• Various municipal and corporate vendor pools

For more information, visit our career site: www.gofortuna.com

Interested? Apply Today!