Remote Psychiatrist – Medicaid Prior Authorization

Gainwell Technologies; Northern (KY); Hybrid; USD 234,000 - 280,000; Part time

Benefits offered by this job

Flexible vacation policy

401(k) employer match

Comprehensive health benefits

Educational assistance

Job summary

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

You will apply clinical judgment across complex cases, participate in peer discussions with providers, and support access to cost-effective care.

Qualifications

• MD/DO with Psychiatry specialty required.
• Unrestricted US medical license required.
• Physically located in the United States.
• Experience in Prior Authorization and/or Utilization Review, preferably in Medicaid or managed care.

Responsibilities

• Provide medical expertise and clinical oversight for utilization management decisions.
• Review medical necessity requests and documentation against program guidelines.
• Engage in peer-to-peer discussions with providers to inform clinical decisions.
• Review complex cases and assist with appeals as needed.
• Collaborate with cross-functional teams to improve program effectiveness and access to care.

Skills

Clinical oversight

Utilization management

Medical leadership

Regulatory interpretation

Peer-to-peer discussions

Analytical skills

Time management

Independent work

Education

MD/DO with Psychiatry

Job description

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

You will apply clinical judgment across complex cases, participate in peer discussions with providers, and support access to cost-effective care.