Job Description
Job Summary:
We are seeking a dedicated Psychiatrist Physician Reviewer to provide essential leadership and clinical expertise in our peer review and utilization review processes. In this role, you will conduct phone consultations with various hospitals in Illinois to determine medical necessity and continued stay criteria for Medicaid Fee-For-Service beneficiaries. This position is PRN and allows for remote work within the state of Illinois.
Job Responsibilities:
Conduct peer-to-peer physician consultations as needed and document findings.
Offer clinical expertise in planning and setting goals to enhance clinical operations.
Represent our organization during state appeal processes.
Review medical information trends and experiences to assist in developing strategic plans for clinical improvements.
Attend stakeholder engagement meetings to provide program representation.
Ensure compliance with all regulatory and accreditation standards.
Stay updated on national, state, and local regulations that affect the healthcare profession.
Promote our organization at seminars, professional societies, medical staff meetings, and other relevant settings.
Why Join Us?
We are a collaborative team of experienced leaders, clinicians, innovative technologists, and industry professionals who are committed to redefining the standards of the healthcare industry. We partner with state and federal healthcare agencies, providers, and employers to deliver better healthcare and improve health outcomes.
You will have the opportunity to engage in meaningful work that makes a genuine difference in people's lives nationwide. We value our employees and provide the tools and support needed to excel in your career.
Thank You!
We appreciate your interest in this position. Due to the high volume of applicants, only those selected for further consideration will be contacted. We encourage you to apply for future openings that align with your interests. Best of luck in your job search!
Equal Opportunity Employer
We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by applicable federal, state, or local law.
Requirements:
Licensed Physician (MD/DO) in Illinois.
Board Certification in your specialty.
Active practice engagement.
Admitting or staff privileges at one or more hospitals or state facilities in Illinois.
Experience in Utilization Management, Case and Disease Management, with knowledge of Medicaid and Medicare programs.
Familiarity with standards of practice for determining levels of care.
Relevant experience navigating complex Medicaid programs.
Proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
Compensation:
The pay rate for this position is $125 per hour.
Employment Type: Full-Time
Salary: $ 125.00 Per Hour
Job Tags
Hourly pay, Full time, Relief, Local area,