Medical Director - PRN - (Maine - Psychiatrist, Licensed in Maine)

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

Acentra seeks a Medical Director - PRN - (Maine - Psychiatrist, Licensed in Maine) to join our growing team.

Job Summary:

The purpose of the Medical Director - PRN position is to provide the principal senior clinical leadership and clinical expertise to operations on all medical aspects relating to the peer review process, utilization review activities, case management, and/or other activities requiring clinical leadership and consultation for the Maine Administrative Services Organization (ASO) which clinical reviews behavioral health and substance use services.

The Medical Director - PRN serves as the senior clinical authority for the program and must be a licensed psychiatrist with an active, unrestricted license in the State of Maine.

Additional key responsibilities may include assisting and promoting business development and strategic planning activities.

In addition to internal clinical leadership responsibilities, the Medical Director is responsible for representing Acentra Health on all reconsideration decisions involving adverse determinations and serves as the designated clinical representative for the State of Maine and Acentra Health during administrative appeal hearings. This includes providing independent clinical judgment, written medical necessity determinations, and oral testimony as required.

The Medical Director - PRN ensures that all clinical decisions are evidence-based, defensible, and compliant with applicable state and federal regulations, MaineCare policy, accreditation standards, and Acentra Health policies and procedures.

***This position is remote and PRN; however, candidates must be a licensed psychiatrist with an active, unrestricted license in the State of Maine***

Job Responsibilities:

• Responsible for oversight of clinical decision-making aspects of the program and provides clinical guidance.
• Evaluate, redirect and/or respond to inquiries from physicians, providers, and customers.
• Consult with general and/or specialty practitioners regularly and as necessary as business needs require.
• Represent and promote company and Acentra Health at seminars, professional societies, hospital medical staff meetings, and other professional settings as appropriate.
• Foster appropriate external relationships with attending physicians/surgeons by response to telephone calls and letters, speaking engagements before physician and provider organizations.
• Analyze and remain current on national, state, and local regulations and legislation including MaineCare policy and federal behavioral health requirements, which impacts the health care profession.
• Review medical information trends, experiences, and approaches, and assists in the development of strategic plans for clinical improvements.
• Ensures compliance with regulatory and accreditation requirements including URAC and applicable state and federal standards.
• Responsible for oversight of medical content of company publications and clinical guidance documents.
• Participate in activities specific to contractual arrangements, i.e., Fair Hearings, including serving as the clinical representative for Acentra Health and the State of Maine in administrative appeal hearings and reconsideration processes related to adverse determinations.
• Provide medical expertise with respect to planning and establishing goals and policies to improve medical management.
• Provides oversight of physician consultants and advisors. Conducts peer-to-peer physician consultations as requested/required, documents consultations and renders final clinical opinions when required.
• Work with medical, nursing, and administrative staff to identify matters needing shared attention.
• Discuss, inform, and facilitate communication and interaction between staff with customers and state stakeholders as appropriate.
• Other duties as assigned.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

The list of responsibilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary.

Qualifications

Required Qualifications/Experience:

• A minimum of 5+ years of active clinical practice.
• A minimum of 5+ years of experience as a physician executive with significant accomplishments in developing managed care strategies, integrating delivery systems, improving quality and utilization management programs.
• Medical License, MD or DO, as a Psychiatrist must be current and in the state of Maine.
• Board certification in a clinical specialty in the state of Maine.

Preferred Qualifications/Experience:

• Demonstrated expertise in quality assurance and utilization review is a prerequisite.
• A modern clinician well-versed in significant trends within healthcare and managed care.
• Possesses the ability to collaborate effectively with a diverse range of personalities, exhibiting approachability, respect, and consensus-building skills.
• A systems thinker with robust organizational abilities, capable of seamlessly integrating various components to ensure on-time and budget-compliant delivery.
• Adaptable, with a strong collaborative management style, characterized by creative thinking, high energy, enthusiasm, and a commitment to promoting teamwork.
• Demonstrates the ability to adapt to frequently changing work parameters.

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.

Benefits

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

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

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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 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 $220,640.00 - USD $281,000.00 /Yr.