Job Description
Job Summary:
We are seeking a dedicated Psychiatrist Physician Reviewer to lead and provide clinical expertise in the peer review process, utilization review activities, and other areas requiring clinical leadership and consultation. This role involves conducting phone consultations with hospitals in Illinois to determine medical necessity and continued stay criteria for Medicaid Fee-For-Service beneficiaries. This position is PRN and remote within the state of Illinois.
Key Responsibilities:
Conduct peer-to-peer physician consultations as needed and document the outcomes.
Offer clinical expertise to enhance clinical operations by planning and setting goals and policies.
Represent the organization during state appeal processes.
Review and analyze medical information trends and approaches to help develop strategic plans for clinical improvements.
Participate in stakeholder engagement meetings to represent the program effectively.
Ensure compliance with regulatory and accreditation requirements.
Stay current with national, state, and local regulations and legislation affecting the healthcare profession.
Represent and promote the organization at seminars, professional societies, medical staff meetings, and other professional events.
Why Join Us?
We are a team of compassionate leaders, clinicians, and technologists committed to setting new standards in healthcare. Our collaborative environment ensures that we support each other in delivering exceptional care and improving health outcomes. We offer a meaningful role where your work will positively impact lives nationwide. You will receive the tools and encouragement needed to achieve your career goals.
Application Process:
Thank you for considering this opportunity. We value your time and appreciate your application. Due to the volume of applications, only those selected for further consideration will be contacted. We encourage you to apply for future positions that match your interests and expertise.
Best of luck in your job search!
Requirements:
Licensed Physician (MD/DO) with the ability to practice in Illinois.
Board Certification in your specialty.
Active practice experience.
Admitting or staff privileges in one or more Illinois hospitals or state facilities.
Experience in Utilization Management, Case and Disease Management with a strong understanding of Medicaid and Medicare programs.
Familiarity with standards of practice related to determining levels of care.
Knowledge of Medicaid programs and experience navigating complex projects.
Proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
Compensation:
$125 per hour.
Employment Type: Full-Time
Salary: $ 125.00 Per Hour
Job Tags
Hourly pay, Full time, Relief, Local area,