Prior Authorization Psychiatrist – Part-Time Contractor

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Act as a clinical subject matter expert for staff, leadership, clients, and providers.

• Perform medical necessity evaluations for requested services, medications, and procedures using established clinical criteria.

• Engage in peer-to-peer discussions with providers.

• Analyze complex clinical cases, documentation, and healthcare-related matters.

• Aid in utilization management activities and reviews of medically complex claims.

• Interpret clinical, regulatory, and procedural guidelines to facilitate accurate decision-making.

• Collaborate with cross-functional teams to enhance program effectiveness, quality outcomes, and access to care.

• Participate in the appeals process when necessary.

• Provide medical expertise and clinical oversight for utilization management and prior authorization processes in a Medicaid-focused healthcare setting.

⛳️ Requirements

• Medical degree (MD or DO) specializing in Psychiatry.

• Unrestricted medical practice license in the United States.

• Must be physically located in the United States.

• Post-graduate experience in direct patient care.

• Experience in Prior Authorization and/or Utilization Review, ideally within Medicaid or managed care settings.

• Proven experience in providing clinical oversight and medical leadership.

• Familiarity with Medicaid and healthcare utilization management.

• Strong clinical judgment and decision-making capabilities.

• Exceptional verbal and written communication skills.

• Ability to interpret complex clinical, regulatory, and procedural documents.

• Strong analytical, organizational, and time management abilities.

• Proficiency in standard computer applications.

• Capability to work independently while effectively collaborating across teams.

• Candidates must be located within the United States during their work.

🏝️ Benefits

• Flexible hours.

• Work-life balance.

• Continuous learning and career development opportunities.

• Flexible vacation policy (for eligible salaried, full-time candidates).

• 401(k) employer match (for eligible salaried, full-time candidates).

• Comprehensive health benefits (for eligible salaried, full-time candidates).

• Educational assistance (for eligible salaried, full-time candidates).

• Leadership and technical development academies.

• Flexibility for remote work.