Job Description

Company Overview

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 Summary and Responsibilities

Acentra Health is looking for a Medical Reviewer - Psychiatrist - Must be Licensed in Arkansas - PRN (Remote within the U.S.) to join our growing team.

Job Summary:

• The Psychiatrist takes on a crucial role by providing clinical leadership for peer and utilization review activities within the company. Responsibilities include conducting case consultations to determine medical necessity for beneficiaries, contributing to the overall effectiveness and quality of mental health services.

Responsibilities:

• Completes prior authorization, continued stay, retroactive and retrospective reviews for Inpatient and Outpatient Behavioral Health cases, within predetermined timeframes.
• Performs second-level review utilizing Arkansas Medicaid manuals for service criteria.
• Collaborates with Team Supervisor and Medical Director to complete cases timely, accurately and within review system specifications.
• Provide clinical expertise to help plan and establish goals and policies aimed at improving clinical operations.
• Represent the organization in state appeal processes.
• Review trends, experiences, and approaches in medical information.
• Assist in developing strategic plans for clinical improvements.
• Ensure compliance with regulatory and accreditation requirements.
• Analyze and stay current on national, state, and local regulations and legislation that impact the healthcare profession.
• Assess and analyze psychological, emotional, behavioral, and physical functioning.
• Develop level of care recommendations based on clinical evaluations.
• Determine a clinical diagnosis accounting for psychological and behavioral issues.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

The above list of responsibilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.

Qualifications

Required Qualifications/Experience:

• Licensed Psychiatrist (MD/DO) in the State of Arkansas.
• Board Certification.
• Experience in Utilization Management, Case and Disease Management with knowledge of Medicaid programs.

Preferred Qualifications/Experience:

• Familiarity with the Parity Rule regarding Mental Health and Substance Use Disorder Services (Title 42 of the CFR, part 438.910).
• Experience with Medicaid programs and navigating similar complex projects.
• Knowledge of psychiatric disorders as defined by the most current Diagnostic and Statistical Manual.
• Knowledge of standards of practice related to determining the Level of Care.
• Knowledge of standards of practice related to mental health and other disorders that typically require psychiatric inpatient care.
• Proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
• Ability to use computer equipment and web-based software for work purposes.
• Ability to communicate effectively with healthcare professionals, patients, their families, and other support groups.
• Ability to communicate effectively through spoken, written, and electronic media.
• Strong attention to detail.
• Ability to prioritize and execute tasks effectively and efficiently.

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.

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.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

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 who are 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

Visit us at

EEO 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, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

Pay Range

USD $125.00 - USD $130.00 /Hr.

Job Tags

Relief, Local area,

Similar Jobs