Position : Psychiatrist Director, Utilization Management (Behavioral Health)
Company : Large Health Insurance Company
Location : 100% Remote
Duration : 3 6 month contract
Schedule : Per diem or Part-time hours
Start Date : ASAP
Summary :
Our large payer client is seeking a Psychiatrist Medical Director, Utilization Review (Behavioral Health) to join their team to assist with UM work on a per diem basis.
Duties includes inpatient reviews, case management reviews, and out of network reviews based on the clients appeals & provider disputes.
Qualifications & Overview of Duties :
- Board certified Psychiatrist with an active license in your current state of residence.
- Experience working with Milliman (MCG) guidelines preferred.
- 90% of the work is on this side using Milliman (inpatient), 10% of the work will be focused within Concurrent Reviews using MCG guidelines
- Targeted case management reviews for state of FL for DSNIP members
- Out of network reviews & TCM 10% of all cases
Behavioral Health UM Director (Psychiatrist) -, IL
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