Pediatric Physician Reviewer - PRN (Remote Illinois)
Location | Lombard Illinois United States |
Salary | |
Remote | 🌴Remote allowed |
First listed | In the last 7 months |
Company Info | 👉 See Acentra Health company tax, EIN & IRS information |
Job Description
Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.
Pediatric Physician Reviewer (PRN) - Remote
- Are you an experienced Physician Reviewer looking for a new challenge?
- Are you looking to join a team that ensures a collaborative and inviting culture where everyone can thrive?
This is a PRN opportunity to work remotely in Illinois.
The selected candidate must possess an active Illinois MD/DO License.
If so, you might be our next new team member!
Who we need:
A Pediatric Physician Reviewer who will provide principal leadership and clinical expertise to operations relating to the peer review process, utilization review activities, and other activities requiring clinical leadership and consultation. Conducts phone consultations with various Illinois hospitals to establish medical necessity and continued stay criteria for IL Medicaid Fee-For-Service beneficiaries.
Why us?
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.
Singularly Focused. Mission Driven.
Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.
We do this through our people.
You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.
What you’ll do:
- Conduct peer-to-peer physician consultations as requested/required and document consultations.
- Provide clinical expertise with respect to planning and establishing goals and policies to improve clinical operations.
- Represent the organization through state appeal processes.
- Review medical information trends, experiences, and approaches and assist in the development of strategic plans for clinical improvements.
- Provide program representation at stakeholder engagement meetings.
- Ensure compliance with regulatory and accreditation requirements.
- Analyze and remain current on national, state, and local regulations and legislation which impact the healthcare profession.
- Represent and promote Acentra Health at seminars, professional societies, medical staff meetings, and other professional settings as appropriate.
What you’ll need:
Required Qualifications
- Licensed Physician (MD/DO) to practice in all branches in Illinois.
- Board Certification in Pediatrics.
- Engaged in active practice.
- Has admitting or staff privileges in one or more Illinois hospitals or state facilities.
Knowledge, Skills, Abilities
- Knowledge of the American Board of Pediatrics (ABP) established standards.
- Knowledge of Medicaid programs with relevant experience navigating similar complex projects.
- Knowledge of standards of practice related to the determination of level of care.
- Knowledge of standards of practice related to diagnosis and treatment of acute and chronic diseases in children from birth to young adulthood, typically requiring inpatient admission.
- Knowledge and understanding of public sector services and supports.
- Computer proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
- Ability to utilize computer equipment and web-based software to conduct work.
- Ability to interact with various office staff as needed to support necessary workflows.
- Ability to interact with healthcare professionals, patients, their families, and other supports.
- Ability to communicate effectively to individuals and groups through spoken, written, and electronic media.
- Ability to attend to detail, effectively prioritize, and execute tasks in a timely manner.
- Assess and analyze psychological, emotional, behavioral, and physical functioning.
- Develop the level of care recommendations based on clinical evaluations.
Experience
- Experience in Utilization Management, Case and Disease Management with knowledge of Medicaid and Medicare programs.
Thank You!
We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!
~ The Acentra Health Talent Acquisition Team
EOE AA M/F/Vet/Disability
Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.
;Apply to Job
👉 Please mention that you found the job on RemotePhysicianJobs.org, this helps us get more remote physician jobs & companies listed here, thanks!
Get a referral to Acentra Health
If possible, try to get a warm intro/referral to Acentra Health before applying! Do a LinkedIn search to see who you may know at the company. See this LinkedIn from Steven for more details on this tactic.
More jobs from Acentra Health
Get job alerts & stay up to date via our newsletter:
Remote physician jobs jobs by role
Cardiology jobsDermatology jobsMedical Director jobsMedical Science Liaison jobsOB-GYN jobsPart-Time jobsPediatrics jobsPhysician jobsPrimary Care jobsPsychiatry jobsUrgent Care jobsUtilization Management jobsRemote physician jobs jobs by organization
Journey Clinical jobsJustAnswer jobsK Health jobsKEPRO jobsKMG Medical Group jobsKarius jobsKaruna Therapeutics jobsKaryopharm Therapeutics jobsKasten jobsKiira jobsKiniksa Pharmaceuticals jobsKite Pharma jobsKlarity Health jobsKriya Therapeutics jobsKrystal Biotech jobsKyowa Kirin jobsKyverna jobsKyverna Therapeutics jobsLENZ Therapeutics jobsLIfeMD jobsLabcorp jobsLee Health jobsLegend Biotech jobsLegion Health jobsLief Therapeutics jobsLifePoint Health jobsLifeStance Health jobsLifestyleRx jobsLittle Otter jobsLivongo jobsLongboard Pharmaceuticals jobsLumeris jobsLuna jobsLundbeck jobsLykos Therapeutics jobsLyra jobsM13 jobsM3 jobsMBX Biosciences jobsMCG Health jobsMDCalc jobsMDLIVE jobsMEDIjobs jobsMagellan Health jobsMantra Health jobsManual jobsMarathon Health Inc jobsMartin Army Community Hospital jobsMass General Brigham jobsMatchwell jobsMaven Clinic jobsMayo Clinic jobsMcKesson jobsMechanism Ventures jobsMediBuddy jobsMedical College of Wisconsin jobsMedical University of South Carolina jobsMednet jobsMedpace jobsMedtronic jobsMemora Health jobsMerative jobsMerck jobsMercy Health jobsMicroVention jobsMidi Health jobsMiga Health jobsMindCare Solutions jobsMindbloom jobsMindoula Health jobsMinuteClinic jobsModRN Health jobsMoffitt Cancer Center jobsMolina Healthcare jobsMondelez International jobsMonogram Health jobsMontefiore Medical Center jobsMonument jobsMosaic Life Care jobsMount Sinai Health System jobsMovn Health jobsMoxie jobsN-Power Medicine jobsNCR jobsNEA Baptist jobsNatera jobsNeko Health jobsNeumora jobsNeumora Therapeutics jobsNeura Health jobsNeurocrine Biosciences jobsNew Century Health jobsNew York Life Insurance jobsNoom jobsNorthwell Ventures jobsNovant Health jobsNovartis jobsNovo Nordisk jobsNovo Nordisk US jobsNutrafol jobsNuvoAir jobsOSF HealthCare jobsOak Street Health jobsOchsner Health jobsOncoHealth jobsOne Medical jobsOpenLoop jobsOpenwater jobsOphelia jobsOptions MD jobsOptum jobsOrca Bio jobsOrdinary Folk jobsOrganogenesis jobsOscar Health jobsOsmosis jobsOtsuka Pharmaceutical Companies jobsOurHealth jobsPRECISIONvalue jobsPacific Northwest National Laboratory jobsPair Team jobsPall jobsPall Corporation jobsPalta jobsParadigm jobsParexel jobsParsley Health jobsPartners In Health jobsPath jobsPatina jobsPearl Health jobsPeloton Therapeutics jobsPenn Medicine Lancaster General Health jobsPenn State Health jobsPeraton jobsPersonal Genome Diagnostics jobsPfizer jobsPharvaris jobsPhoenix jobsPhoenix Digital Health jobsPiedmont Healthcare jobsPine Park Health jobsPlug Power jobsPlume jobsPlushCare jobsPocket Naloxone jobsPomelo Care jobsPortrait jobsPoseida Therapeutics jobsPrecision For Medicine jobsPrecision Medicine Group jobsPresbyterian Healthcare Services jobsPrilenia jobsPrisma Health jobsPrivia Health jobsProthena jobsProvidence St Joeseph's Health jobsPurpose Med jobsPursueCare jobsQuadrant Biosciences jobsQuartet Health jobsQuidelOrtho jobsRTI International jobsRWJBarnabas Health jobsRadiology Partners jobsRappore jobsRaytheon Technologies jobsRedesign Health jobsRegroup Therapy jobsReliance HMO jobsReliance Health jobsRemeGen Biosciences jobsRenal Treatment Centers jobsReplimune jobsRestore Hyper Wellness jobsRevero jobsRho jobsRialtic jobsRippl jobsRippl Care jobsRo jobsRoyal Caribbean Group jobsRula jobsRune Labs jobsSAGE Therapeutics jobsSSM Health jobsSSM Health Cardinal Glennon Children's Hospital jobsSaint Louis University jobsSana Benefits jobsSana Biotechnology jobsSanofi jobsSavara jobsScholar Rock jobsScience 37 jobsScience Magazine jobsSeason Health jobsSeasoned Recruitment jobsSecond Opinions jobsSedgwick Claims Management Services jobsSeer jobsSensible Care jobsSeon Design jobsSesame jobsSharpRank jobsShriners Children's jobsSitka jobsSketchy jobsSmarterDx jobsSolace jobsSolace Health jobsSoligent jobsSomatus jobsSonderMind jobsSonova Group jobsSpark Therapeutics jobsSpora Health jobsSprinter Health jobsSt. Bernard's Healthcare jobsSt. Francis - Emory Healthcare jobsState University of New York Upstate Medical University jobsState of Oklahoma jobsSteadyMD jobsStealth jobsStealth Ventures at Redesign Health jobsStory Health jobsStryker jobsSummit Spine and Joint Centers jobsSurgery Partners jobsSynapticure jobsTESARO jobsTailorCare jobsTakeda Pharmaceutical Company Limited jobsTalkiatry jobsTalkspace jobsTarsus Pharmaceuticals jobsTeladoc Health jobsTeleClinic jobsTelemedi jobsTembo Health jobsTempus jobsTempus Labs jobsTenable jobsTenet Healthcare jobsThe Permanente Medical Group jobsThe Skin Clique jobsThermo Fisher Scientific jobsThree Wire Systems jobsTimelyMD jobsTr1X jobsTravere Therapeutics jobsTrialSpark jobsTrinity Health (HQ Michigan) jobsTris Pharma jobsTruist jobsTutorfly jobsTwin Health jobsU.S. Bancorp jobsU.S. Department of Veteran Affairs jobsUNC Health jobsUPMC jobsUSAA jobsUWorld jobsUltragenyx Pharmaceutical jobsUnited Therapeutics Corporation jobsUnitedHealth Group jobsUnitedHealthcare jobsUnityPoint Health jobsUniversity Marine Medical jobsUniversity of Colorado Health jobsUniversity of Maryland Baltimore jobsUniversity of Maryland Medical Systems jobsUniversity of Texas jobsUniversity of Washington jobsUpScriptHealth jobsUpToDate jobsVIGILINT jobsVON Canada jobsVarsity Spirit jobsVeeam Software jobsVentureFizz jobsVera Therapeutics jobsVeracode jobsVeracyte jobsVerily jobsVertex Pharmaceuticals jobsVida Health jobsViewFi jobsVir Biotechnology jobsVirta Health jobsVisana Health jobsVitable Health jobsViventium jobsVizient jobsVynca jobsW.L. Gore & Associates jobsWake Forest Baptist Medical Center jobsWayUp jobsWeightWatchers jobsWelbeHealth jobsWellBe Senior Medical jobsWellinks jobsWest Virginia University Medicine jobsWestern Governors University jobsWheel jobsWinona jobsWorkit Health jobsWunderman Thompson jobsX4 Pharmaceuticals jobsXSOLIS jobsYou Health Medical Groups jobsZivian Health jobsbioMérieux jobschiesirarediseases.com jobseviCore healthcare jobsinsitro jobsmyLaurel jobs© 2024 RemotePhysicianJobs.org. All rights reserved.
Some logos provided by Clearbit.Get matched with jobs