Psychiatrist-PRN

Acentra Health; United States; On-site; USD 122,000 - 207,000; Full time

Benefits offered by this job

401(k) Plan with company match

Wellness programs

Employee Assistance Program (EAP)

Job summary

Acentra Health in the United States is seeking a licensed Psychiatrist to provide clinical leadership for peer and utilization review activities within the company. You will conduct essential phone consultations with state psychiatric hospitals to determine medical necessity for Medicaid beneficiaries.

This role requires board certification and strong knowledge of Medicaid/Medicare programs, with duties including reviews, peer-to-peer consultations, regulatory compliance, and representing the

Qualifications

• Licensed Psychiatrist (MD/DO) licensed in Indiana.
• Board Certification required.
• Experience in Utilization Management.
• Knowledge of Medicaid and Medicare programs.

Responsibilities

• Conduct medical necessity reviews for state Medicaid plan using federal, state, and nationally recognized criteria along with clinical expertise.
• Conduct peer-to-peer consultations between physicians and document the consultations as needed.
• Represent the organization in state appeal processes as needed.
• Partner with leadership to report provider trends noticed in case documentation.
• Ensure compliance with regulatory and accreditation requirements.
• Promote the organization at professional meetings and seminars.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

Skills

Utilization Management

Medicaid knowledge

Medicare knowledge

Attention to detail

Education

MD/DO Licensed in Indiana

Board Certification

Job description

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.

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. At Acentra Health, we embrace emerging technologies, including artificial intelligence and advanced analytics that can be utilized to improve processes, enhance decision-making, and drive better health outcomes. We value professionals who are curious about new technologies and motivated to use innovative tools to increase efficiency, quality, and impact in their roles.

Job Summary And Responsibilities

Job Summary

• The Psychiatrist takes on a crucial role by providing clinical leadership for peer and utilization review activities within the company. They conduct essential phone consultations with the State psychiatric hospitals to determine the medical necessity for Medi-Cal beneficiaries.

Responsibilities

• Conduct medical necessity reviews for state Medicaid plan using federal, state, and nationally recognized criteria along with clinical expertise.
• Conduct peer-to-peer consultations between physicians and document the consultations as needed.
• Represent the organization in state appeal processes as needed.
• Partner with leadership to report provider trends noticed in case documentation.
• Ensure compliance with regulatory and accreditation requirements.
• Promote the organization at professional meetings and seminars.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Qualifications

Required Qualifications

• Licensed Psychiatrist (MD/DO) in the State of Indiana.
• Board Certification is required.
• Experience in Utilization Management.
• Knowledge of Medicaid and Medicare programs.

Preferred Qualifications

• Familiarity with the Parity Rule regarding Mental Health and Substance Use Disorder Services.
• Experience with Medicaid programs and navigating complex projects.
• Knowledge of psychiatric disorders as defined by the DSM.
• 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. This position includes access to select Acentra Health benefits and programs, such as participation in the Acentra Health 401(k) Plan with company match, access to wellness and employee discount programs, and Employee Assistance Program (EAP) resources.

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, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Experience in Lieu of Degree

For non-clinical roles, or when not required by the contract specifically, the Company acknowledges that practical, hands-on experience can provide skills and competencies equivalent to formal education. As such, in cases where a Bachelor's degree may be required, the Company will accept a minimum of six (6) years of directly relevant professional experience in lieu of a degree. In instances where the candidate has an Associate's degree, the Company will accept a minimum of three (3) years of directly relevant professional experience in lieu of the Bachelor's degree.

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.”

Pay Range

USD $88.54 - USD $150.00 /Hr.