Psychiatrist-PRN

Acentra Health, LLC • UNAVAILABLE, UNAVAILABLE

5d

About The Position

Acentra Health is seeking a Psychiatrist to provide clinical leadership for peer and utilization review activities. The role includes conducting phone consultations with state psychiatric hospitals to determine the medical necessity of care for Medi-Cal beneficiaries. The Psychiatrist will apply clinical expertise and recognized criteria while supporting compliance, appeals, and provider-trend reporting.

Requirements

• Licensed Psychiatrist (MD or DO) in the State of Indiana.
• Board certification.
• Experience in Utilization Management.
• Knowledge of Medicaid and Medicare programs.

Nice To Haves

• Familiarity with the Parity Rule regarding Mental Health and Substance Use Disorder Services.
• Experience with Medicaid programs and navigating complex projects.
• Knowledge of psychiatric disorders as defined by the DSM.
• Strong attention to detail and ability to prioritize tasks.

Responsibilities

• Conduct medical necessity reviews for a state Medicaid plan using federal, state, and nationally recognized criteria, together with clinical expertise.
• Conduct peer-to-peer consultations between physicians and document the consultations as needed.
• Represent the organization in state appeal processes as needed.
• Partner with leadership to report provider trends identified in case documentation.
• Ensure compliance with regulatory and accreditation requirements.
• Promote the organization at professional meetings and seminars.
• Read, understand, and adhere to corporate policies, including HIPAA Privacy and Security Rules.
• Perform other education- and experience-related duties that management may deem necessary.

Benefits

• Participation in the Acentra Health 401(k) Plan with company match.
• Access to wellness programs.
• Access to employee discount programs.
• Employee Assistance Program (EAP) resources.

What This Job Offers

• Education Level: Ph.D. or professional degree