Job Description

Job Summary:

We're seeking a dedicated Psychiatrist Physician Reviewer to lead and provide clinical expertise for our peer review and utilization review processes. In this role, you'll engage in phone consultations with hospitals across Illinois to assess medical necessity and determine continued stay criteria for Medicaid Fee-For-Service beneficiaries. This is a PRN (as-needed) remote position within Illinois.

Key Responsibilities:

Conduct peer-to-peer consultations with physicians as needed and document these interactions thoroughly.
Offer clinical guidance in developing and refining goals and policies to enhance clinical operations.
Represent our organization in state appeal processes.
Review and analyze medical information trends and assist in creating strategic plans for clinical improvements.
Participate in stakeholder engagement meetings to represent our program.
Ensure adherence to regulatory and accreditation standards.
Stay updated on relevant national, state, and local healthcare regulations and legislation.
Represent our organization at seminars, professional societies, medical staff meetings, and other relevant events.
Why Join Us?

At our organization, we are a team of compassionate and innovative professionals dedicated to transforming the healthcare landscape. We work with state and federal agencies, healthcare providers, and employers to ensure superior healthcare and improved outcomes. Our team values each member and provides the support and resources needed to excel in your career and make a positive impact on lives nationwide.

Thank You for Your Interest!

We appreciate the time you've taken to consider this opportunity. Due to the high volume of applications, only candidates selected to advance in the interview process will be contacted. We value your interest and encourage you to apply for future openings that match your interests and qualifications.

Requirements:

Licensed Physician (MD/DO) with the ability to practice across all branches in Illinois.
Board Certification in your specialty.
Currently engaged in active practice.
Admitting or staff privileges at one or more Illinois hospitals or state facilities.
Experience in Utilization Management, Case and Disease Management, and familiarity with Medicaid and Medicare programs.
Knowledgeable about standards of practice related to determining the level of care.
Proficient in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
Compensation:

$125 per hour, with consideration based on experience and skill level.
Employment Type: Full-Time
Salary: $ 125.00 Per Hour

Job Tags

Hourly pay, Full time, Relief, Local area, Remote job,

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