Remote Assistant Medical Director, Psychiatry (Part-Time)

Premera; Mountlake Terrace, Orcas (WA, WA); Remote; USD 215,000 - 386,000; Part time

Benefits offered by this job

Medical, vision, dental coverage

Tuition assistance

Retirement plan (401K)

Job summary

Premera is seeking an Assistant Medical Director (psychiatry) to perform clinical reviews and determine coverage based on medical necessity and policy. The role supports disease and case management, and collaborates with nursing and other staff to explore care options for members.

This is a part-time position at 20 hours per week. Required credentials include an MD or DO, unrestricted WA/AK licensure (or ability to obtain), and board certification in psychiatry with five years of clinical

Qualifications

• Must hold MD or DO with unrestricted license in WA or AK or ability to obtain in 90 days.
• Current board certification in psychiatry required.
• Minimum five years of clinical psychiatry experience; health plan reviews preferred.

Responsibilities

• Perform clinical review of case types including pre-, post-, and concurrent behavioral health services.
• Act as final decision maker for coverage based on medical necessity and contract terms.
• Support peer-to-peer discussions with external physicians and collect clinical history.
• Participate in the development and annual review of medical review criteria.

Skills

Clinical review

Medical policy

Communication with physicians

Team collaboration

Education

MD or DO degree

Board certification in Psychiatry

Tools

CPT

ICD

RBRVS

Job description

Premera is seeking an Assistant Medical Director (psychiatry) to perform clinical reviews and determine coverage based on medical necessity and policy. The role supports disease and case management, and collaborates with nursing and other staff to explore care options for members.

This is a part-time position at 20 hours per week. Required credentials include an MD or DO, unrestricted WA/AK licensure (or ability to obtain), and board certification in psychiatry with five years of clinical