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Director, Medical Director - Pennsylvania, United States - The Jacobson Group
Description
Job Description:
A health plan is looking for a Behavioral Health Medical Director to conduct electronic reviews of escalated cases against medical policy criteria, complete initial determinations of cases, review appeals andgrievances, and compose clear andconcise rationale for member and provider determination notifications all while adhering to required compliance standards.
In addition, this professional will ensure all aspects of the medical management process are consistent with community standards of care.
This opportunity is anticipated to be 3+ months in duration and is work-from-home.Requirements:
~ Active and unrestricted Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO) license in Pennsylvania or Delaware, specializing in psychiatry
~1+ year of medical management experience at a health plan
~ Strong knowledge of the managed care industry
~ Skilled in utilization management
Contact:
Karrie Ruch
Refer a Colleague:
Do you know someone who would be interested in this project? Submit your referral directly by emailing the Jacobson contact listed above or submitting them through this form .
If your referral is hired for a contract assignment and meets all other eligibility criteria, you will receive a referral bonus#J-18808-Ljbffr