Psychiatrist Physician Reviewer (PRN)

Acentra Health; Illinois; Remote; USD 200,000 - 250,000; Full time

Job summary

An innovative healthcare company is seeking a Psychiatrist Physician Reviewer to provide clinical leadership in peer review processes and utilization reviews. This role involves conducting consultations with hospitals to assess medical necessity for Medicaid beneficiaries. As part of a dedicated team, you'll have the opportunity to influence health outcomes positively while working remotely within Illinois. Join a passionate group committed to redefining healthcare standards and making a difference in people's lives. This is your chance to take charge of your career and contribute to meaningful health solutions.

Benefits

Comprehensive Health Plans

Paid Time Off

Retirement Savings

Corporate Wellness

Educational Assistance

Corporate Discounts

Qualifications

• Licensed Physician with Board Certification in Psychiatry required.
• Experience in Utilization Management preferred.

Responsibilities

• Conduct peer-to-peer consultations and document findings.
• Provide clinical expertise for planning and policy establishment.
• Ensure compliance with regulatory requirements.

Skills

Clinical Expertise

Peer Review Process

Utilization Review

Knowledge of HIPAA

Attention to Detail

Education

Licensed Physician (MD/DO)

Board Certification in Psychiatry

Tools

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Microsoft Teams

Microsoft Outlook

Job description

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Summary and Responsibilities

Acentra seeks a Psychiatrist Physician Reviewer (PRN) to join our growing team.

Job Summary:

The Psychiatrist Physician Reviewer will provide principal leadership and clinical expertise to operations relating to the peer review process, utilization review activities, and other activities requiring clinical leadership and consultation. They will conduct phone consultations with various Illinois hospitals to establish medical necessity and continued stay criteria for IL Medicaid Fee-For-Service beneficiaries.

*Position is PRN and remote within the state of Illinois.

Responsibilities:

1. Conduct peer-to-peer consultations between physicians and document the consultations
2. Provide clinical expertise to help plan and establish goals and policies
3. Review trends and experiences in medical information
4. Ensure compliance with regulatory and accreditation requirements
5. Develop level of care recommendations based on clinical evaluations
6. Determine clinical diagnoses accounting for psychological and behavioral issues
7. Analyze and remain current on national, state, and local regulations and legislation which impact the healthcare profession
8. Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Qualifications

Required Qualifications

1. Licensed Physician (MD/DO) to practice in all branches in Illinois
2. Board Certification in Psychiatry
3. Engaged in active practice
4. Have admitting or staff privileges in one or more Illinois hospitals or state facilities
5. Knowledge of standards of practice related to the determination of level of care
6. Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook

Preferred Qualifications

1. Experience in Utilization Management
2. Knowledge or experience with Medicaid and Medicare programs
3. Knowledge of psychiatric disorders as defined by the DSM
4. Ability to interact with various office staff as needed to support necessary workflows
5. Strong attention to detail and ability to prioritize tasks

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

“Based on our compensation philosophy, an applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”

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Pay Range

USD $125.00 - USD $125.00 /Hr.