Application deadline date has been passed for this Job.
Doctor for Utilization Review
- Post Date:October 8, 2020
- Views 259
- Company AKUA BEHAVIORAL HEALTH PRIVATE LIMITEDNo. of Positions 1Sector Private
- Salary ₹14,000.00 - ₹20,000.00 per yearQualification Bachelor's (Preferred)Education Graduation
Job Description
Akua Behavioral Health (US COMPANY) is a nationally recognized Mental Health and Substance Abuse treatment program for adults. Accredited by The Joint Commission, Akua meets the highest quality standards for behavioral health and client care.
POSITION: Doctor for Utilization Review
Remote Position: Work from Home at Night
Company: California Healthcare Company
Compensation: 20 Lacs per Year (Base 14 Lacs + Bonus 6 Lacs)
Job Description
- Evaluate patients’ clinical status using evidence-based criteria to determine medical necessity for detox, residential, PHP, and IOP authorizations.
- Complete Initial, concurrent, Peer, and retrospective reviews in a timely manner to ensure continuous coverage.
- Act as a liaison between managed care organizations and the facility’s professional clinical staff.
- Conduct reviews in accordance with certification requirements of insurance plans or other managed care organizations (MCOs) and document all activities in a detailed manner in applicable CRM/EMR
- Inform clinical and medical staff of any specific concerns that would extend or restrict patients’ length of stay.
- Facilitate peer review calls between facility and external organizations.
- Perform concurrent reviews for patients to ensure that extended stays are medically justified and documented in the patient’s medical records.
- Act in coordination with the facility or corporate office’s leadership team to improve the quality of services provided within the organization.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Comply with Akua rules, policies and guidelines consistently
- Maintain Facility Standards and inform supervisor of any deficiencies
- Maintain professionalism in interactions with staff and insurance companies at all times and exercise maturity of judgment
Skills/Experience:
- Must be a Doctor/Dentist (M.D. preferred).
- Must be able to work Nighttime from Home for a California Healthcare company
- Must speak Good English
- Proficient in Excel, Word, and electronic charting
- Ability to work with minimal supervision
Compensation
20 Lacs per Year (Base 14 Lacs + Bonus 6 Lacs)
Schedule:
- Night shift
Supplemental Pay:
- Performance bonus
Experience:
- Healthcare: 1 year (Required)
Language:
- English (Required)
Industry:
- Customer Service
Work Remotely:
- Yes