Community Health Plan of Washington
The Psychiatrist Physician Reviewer conducts medical necessity reviews for behavioral health services across Medicaid, Medicare, and Exchange lines of business. This role supports high-quality, cost-effective care by applying clinical expertise to utilization management decisions.
Key Responsibilities
- • Apply psychiatric clinical knowledge to utilization review activities.
- • Evaluate requests for behavioral health services in alignment with medical policies, clinical guidelines, and regulatory requirements.
- • Identify opportunities to improve review processes, effectiveness, resource utilization, and overall quality.
- • Perform additional duties as assigned.
Required
- • MD or DO degree.
- • Board certification or board eligibility in Psychiatry through the American Board of Psychiatry and Neurology.
- • Active, unrestricted medical license to practice in Washington State.
- • At least 5 years of clinical experience, or an equivalent combination of education and experience.
Preferred
- • Board eligibility or certification in Addiction Psychiatry or Addiction Medicine
- • Board eligibility or certification in Child and Adolescent Psychiatry
Company Overview
Industry: Healthcare Technology
Company Size: 500-1,000 employees
Founded: 2015
Headquarters: San Francisco, CA
Company Links
Key Contacts
Contact information not available
About the Company
Leading healthcare technology company focused on improving patient outcomes through innovative digital solutions. We're transforming the way healthcare is delivered with cutting-edge technology and data-driven insights. Our platform serves over 10,000 healthcare professionals and has processed millions of patient interactions.
Recent News & Updates
Physician Reviewer - Psychiatrist, Utilization Management
Location: Virtual, must reside in the United States.
Schedule: Saturday and Sunday, a total of 6 hours per weekend. Additional weekday hours may be available.
Role Overview:
The Psychiatrist Physician Reviewer conducts medical necessity reviews for behavioral health services across Medicaid, Medicare, and Exchange lines of business. This role supports high-quality, cost-effective care by applying clinical expertise to utilization management decisions.
Key Responsibilities:
- Apply psychiatric clinical knowledge to utilization review activities.
- Evaluate requests for behavioral health services in alignment with medical policies, clinical guidelines, and regulatory requirements.
- Identify opportunities to improve review processes, effectiveness, resource utilization, and overall quality.
- Perform additional duties as assigned.
Minimum Requirements:
- MD or DO degree.
- Board certification or board eligibility in Psychiatry through the American Board of Psychiatry and Neurology.
- Active, unrestricted medical license to practice in Washington State.
- At least 5 years of clinical experience, or an equivalent combination of education and experience.
Preferred Qualifications:
- Board eligibility or certification in Addiction Psychiatry or Addiction Medicine
- Board eligibility or certification in Child and Adolescent Psychiatry
Compensation: Hourly contract position, $155/hour
Keep track of your job search
Save personal notes for each job to track your thoughts, application status, and follow-ups.
Try for freeUpload your resume
Sign up to upload your resume and get AI-powered customization for job applications.
Sign up free