This is an exceptional opportunity to do Utilization Management and drive innovative work around better patient outcomes for our top tier client - a Fortune Top 50 Company.
This position will be supporting the Medicaid business of our client organization.
Responsible for the administration of medical services for the Medicaid health plan regards to Child and Adult Psychiatry services. The plan manages the State's Foster care Program.
This is a 100% remote role.
Primary duties may include, but are not limited to:
Conduct peer to peer reviews
Conduct medication reviews for foster care
Attend occasional fair hearings
Will meet with the State related to Foster care programs
Interprets existing policies and develops new policies based on changes in the healthcare or medical arena.
Leads, develops, directs and implements clinical and non-clinical activities that impact health care quality cost and outcomes.
Psychiatry Board Certification required.
Must possess an active unrestricted medical license to practice medicine in the state of Georgia.
5+ years of clinical experience in Child Psychiatry
Utilization management experience particularly with Appeals a plus
Requires strong oral, written and interpersonal communication skills, problem-solving skills