Psychiatrist Physician Reviewer - PRN - Remote (Within Illinois)

Company Description

CNSI and Kepro are now Acentra Health!  Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company, to actively engage in problem-solving, and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Description

Psychiatrist Physician Reviewer - PRN - Remote (Within Illinois)

• Are you an experienced Psychiatrist Physician Reviewer looking for a new challenge?
• Are you looking to join a team that ensures a collaborative and inviting culture where everyone can thrive?

This is a PRN opportunity to work remotely in Illinois.

The selected candidate must possess an active Illinois MD/DO Psychiatrist License.

If so, you might be our next new team member!

Who we need:

A Physician Reviewer who will provide principal leadership and clinical expertise to operations relating to the peer review process, utilization review activities, and other activities requiring clinical leadership and consultation. Conducts phone consultations with various Illinois hospitals to establish medical necessity and continued stay criteria for IL Medicaid Fee-For-Service beneficiaries.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

Singularly Focused. Mission Driven.

Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

What you’ll do:

• Conduct peer-to-peer physician consultations as requested/required and document consultations.
• Provide clinical expertise with respect to planning and establishing goals and policies to improve clinical operations.
• Represent the organization through state appeal processes.
• Review medical information trends, experiences, and approaches and assist in the development of strategic plans for clinical improvements.
• Provide program representation at stakeholder engagement meetings.
• Ensure compliance with regulatory and accreditation requirements.
• Analyze and remain current on national, state, and local regulations and legislation which impact the healthcare profession.
• Represent and promote Acentra Health at seminars, professional societies, medical staff meetings, and other professional settings as appropriate.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

EOE AA M/F/Vet/Disability

Acentra Health is 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, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

Qualifications

What you’ll need:

Required Qualifications/Experience:

• Licensed Psychiatrist (MD/DO) to practice in all branches in Illinois.
• Board Certification.
• Experience in Utilization Management, Case and Disease Management with knowledge of Medicaid and Medicare programs.
• Engaged in active practice.
• Have admitting or staff privileges in one or more Illinois hospitals or state facilities.<