Physician Reviewer | Psychiatry

Title: Physician Reviewer - Psychiatry

Location: Remote

Duration: 12 Months

Pay- $135

Schedule: Availability 5-6 hours total weekly; roughly 1 hour per day Monday-Friday

Active Maine license as an MD or DO without restrictions, limitations, or sanctions

JOB DESCRIPTION

As the First Level, Physician Reviewer for the client's 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 Client's 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