Remote Psychiatrist for Prior Authorization & Utilization

Gainwell Technologies; Arizona; On-site; USD 234,000 - 280,000; Part time

Benefits offered by this job

Vacation policy

401(k) match

Health benefits

Educational assistance

Leadership academies

Technical development academies

Job summary

Gainwell Technologies seeks a Prior Authorization Physician to provide medical oversight in Medicaid-focused utilization management. This remote, part-time contractor role reviews medical necessity requests, evaluates documentation, and ensures care decisions align with program guidelines.

You will support cost-effective, evidence-based care, collaborate with staff and providers, and help improve access to care while maintaining high clinical standards.

Qualifications

• MD/DO with Psychiatry specialty and unrestricted US license.
• Prior Authorization and/or Utilization Review experience, preferably within Medicaid or managed care environments.
• Ability to interpret complex clinical, regulatory, and procedural documents.

Responsibilities

• Serve as a clinical subject matter expert for staff, leadership, clients, and providers.
• Conduct medical necessity reviews for services, medications, and procedures using established criteria.
• Participate in peer-to-peer discussions with providers to support informed clinical decisions.
• Review complex clinical cases, documentation, and healthcare-related issues.
• Assist with utilization management activities and medically complex claim reviews.
• Interpret clinical, regulatory, and procedural guidelines to support decisions.
• Collaborate with cross-functional teams to improve program effectiveness and access to care.
• Participate in the appeals process when indicated.

Skills

Clinical leadership

Medical decision-making

Excellent communication

Independent work

Collaboration

Education

MD or DO

Job description

Gainwell Technologies seeks a Prior Authorization Physician to provide medical oversight in Medicaid-focused utilization management. This remote, part-time contractor role reviews medical necessity requests, evaluates documentation, and ensures care decisions align with program guidelines.

You will support cost-effective, evidence-based care, collaborate with staff and providers, and help improve access to care while maintaining high clinical standards.