AmeriHealth Caritas Psychiatrist Advisor (Part Time) in Newark, Delaware
Psychiatrist Advisor (Part Time)
AmeriHealth Caritas Delaware is excited to have been chosen as one of the Medicaid managed care plans for the Diamond State Health Plan and Diamond State Health Plan- Plus programs. Backed by a national organization, we have long-term experience serving the Medicaid population in neighboring states. We are committed to delivering health care through innovative services and programs and are looking forward to helping Delaware become an even healthier state.
The Part Time Psychiatrist Advisor (PA) supports the Clinical Department by providing consultation regarding the clinical aspects of specific cases and offering guidance pertaining to best practice standards and quality of care issues. The primary responsibilities include making utilization determinations, as needed, addressing quality concerns through peer to peer consultations. The PA or delegate shall review all denials of care for behavioral health treatment services prior to notifying the Provider and Enrollee in writing. The PA is responsible for activities and consultation regarding program initiatives, committee representation, and process enhancement and providing internal and external training. These activities involve research and data analysis, special projects, program development, evaluation of new services, writing best practice guidelines, and quality monitoring.
The incumbent will adhere to all policies and procedures including but not limited to: Employee Handbook, Corporate Code of Conduct, Confidentiality and the Corporate Compliance Program, which includes Fraud, Waste and Abuse. The position requirements are 5 (four hour) days.
- BH MCO preferred.
- Clinical practice.
- Must hold a valid, unrestricted state medical license in the State(s) they are working in.
- Board Certified in either general psychiatry or child psychiatry.
EOE Minorities/Females/Protected Veterans/Disabled