Psychiatry Clinical Reviewer

Job Summary

A company is looking for a Physician Clinical Reviewer - Psychiatry to join their utilization management team in a remote capacity.

Key Responsibilities

• Act as Behavioral Health Medical Director and participate in case management and utilization management programs
• Review complex cases and discuss determinations with requesting physicians within regulatory time frames
• Ensure compliance with medical review guidelines and participate in quality assurance reviews

Required Qualifications

• Education Level: DO, MBBS, or MD
• Experience Level: 5+ years in a clinical setting
• Must be eligible to work in the United States without a work visa or residency sponsorship
• Clinical expertise in psychiatry/behavioral health
• Ability to participate in ongoing training and testing related to inter-rater reliability