Physician Medical Reviewer - PRN - On-site (Topeka, KS)

Company Overview

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Job Summary and Responsibilities

Job Summary : The Physician Medical Reviewer - PRN, in Topeka, Kansas serves as the physician reviewer, providing expert guidance on utilization management. This role ensures clinical integrity and excellence across clinical review. Responsibilities :

• Provide clinical guidance for all aspects of the program's medical decision-making.
• Respond to and manage inquiries from physicians, providers, and clients, offering clinical evaluation and direction as needed.
• Stay informed on relevant national, state, and local healthcare regulations and legislation.
• Ensure compliance with all applicable regulatory and accreditation standards.
• Participate in contract-specific activities, such as Fair Hearings and other regulatory processes.
• Collaborate with medical, nursing, and administrative teams to address shared concerns and priorities.
• Facilitate effective communication between internal staff and external stakeholders.
• Perform additional duties as assigned.
• Read, understand, and adhere to all corporate policies, including polices related to HIPAA and its Privacy and Security Rules.

This role is contingent upon being awarded a contract. Start dates and final offers are contingent upon the contract award and final contract start dates.

Qualifications

Required Qualifications / Experience :

Preferred Qualifications / Experience :

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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.

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.

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 who are 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

Visit us at Acentra Health

EEO 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, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."

Pay Range

USD $125.00 - USD $150.00 / Hr.