Hire Talent
Physician Reviewer - Psychiatry
Hire Talent, Mc Lean, Virginia, us, 22107
JOB SUMMARYJob Overview: As the F...JOB DESCRIPTION
Job Overview:
As the First Level, Physician Reviewer for the Acentra ME ASO program, the psychiatrist will be responsible for review of clinical recommendations made by Master's level clinicians reviewing prior authorizations and continued stay reviews for behavioral health services in the State of Maine. Case summaries are sent Monday-Friday for physician review for final determination on the cases that have been reviewed. A thorough clinical review of each case has been previously conducted by the clinician to formulate the clinical recommendations sent to the physician reviewer. The daily review process typically takes no more than 1 hour per day.
Summary of Duties:• Review daily case list and clinical recommendation summaries sent by Acentra ME Appeals team.• Provide response regarding agreement with clinical recommendations provided and/or alternative recommendation/rationale regarding the clinical recommendations and reviews conducted by the clinical reviewer within 24 hrs to ME Appeals team.
Availability 5-6 hours total weekly; roughly 1 hour per day Monday-Friday
Minimum Requirements:
Degree as a Medical Doctor of Medicine or Doctor of Osteopathy
Graduation from General Psychiatry Residency
Board Certification by the American Board of Psychiatry and Neurology in Psychiatry
Active Maine license as an MD or DO without restrictions, limitations, or sanctions
Preferred Requirements:• 3-5 years active practice experience• Previous experience in Utilization Management/Utilization Review
Job Overview:
As the First Level, Physician Reviewer for the Acentra ME ASO program, the psychiatrist will be responsible for review of clinical recommendations made by Master's level clinicians reviewing prior authorizations and continued stay reviews for behavioral health services in the State of Maine. Case summaries are sent Monday-Friday for physician review for final determination on the cases that have been reviewed. A thorough clinical review of each case has been previously conducted by the clinician to formulate the clinical recommendations sent to the physician reviewer. The daily review process typically takes no more than 1 hour per day.
Summary of Duties:• Review daily case list and clinical recommendation summaries sent by Acentra ME Appeals team.• Provide response regarding agreement with clinical recommendations provided and/or alternative recommendation/rationale regarding the clinical recommendations and reviews conducted by the clinical reviewer within 24 hrs to ME Appeals team.
Availability 5-6 hours total weekly; roughly 1 hour per day Monday-Friday
Minimum Requirements:
Degree as a Medical Doctor of Medicine or Doctor of Osteopathy
Graduation from General Psychiatry Residency
Board Certification by the American Board of Psychiatry and Neurology in Psychiatry
Active Maine license as an MD or DO without restrictions, limitations, or sanctions
Preferred Requirements:• 3-5 years active practice experience• Previous experience in Utilization Management/Utilization Review