Job Description
Job Summary:
We are seeking a dedicated Psychiatrist Physician Reviewer to provide leadership and clinical expertise in our peer review process, utilization review activities, and other clinical operations. In this role, you will conduct phone consultations with various hospitals across Illinois to assess medical necessity and criteria for continued stay for Medicaid Fee-For-Service beneficiaries.
This is a PRN position that allows you to work remotely within the state of Illinois.
Key Responsibilities:
Conduct peer-to-peer physician consultations as needed and document each interaction.
Provide clinical expertise in planning and establishing goals and policies aimed at enhancing clinical operations.
Represent the organization during state appeal processes.
Analyze medical information trends and experiences to help develop strategic plans for clinical improvements.
Participate in stakeholder engagement meetings to represent our programs.
Ensure compliance with all regulatory and accreditation standards.
Stay informed about national, state, and local regulations and legislation that impact the healthcare field.
Promote our organization at seminars, professional societies, medical staff meetings, and other relevant professional settings.
Why Join Us?
Our team is comprised of compassionate leaders, clinicians, innovative technologists, and industry professionals dedicated to transforming the healthcare experience. We partner with state and federal healthcare agencies, providers, and employers to enhance healthcare quality and improve health outcomes.
When you join us, you will engage in meaningful work that truly makes a difference in people's lives across the nation. We value our employees and are committed to providing you with the tools and support needed to excel in your career.
Thank You!
We appreciate your interest in this position and understand that your time is valuable. Please note that due to the high volume of applications, only those selected for further consideration will be contacted. We encourage you to apply for future opportunities that align with your interests and skills. Best of luck in your job search!
Requirements:
Licensed Physician (MD/DO) with the ability to practice in all branches in Illinois.
Board Certification in your specialty.
Active engagement in clinical practice.
Admitting or staff privileges at one or more Illinois hospitals or state facilities.
Experience in Utilization Management, Case and Disease Management, with a solid understanding of Medicaid and Medicare programs.
Knowledge of standards of practice related to determining levels of care.
Familiarity with Medicaid programs and experience managing complex projects.
Proficient 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,