Behavioral Health Medical Director - Utilization Management (Psychiatry) - Remote

Jubilee Medical Services • Contract • Remote (United States) • from $300 / hour • 8h ago

About

Jubilee Medical Services

Jubilee Medical Services (JMS), PLLC is a physician-led utilization management company providing medical necessity review services to health plans nationwide. We believe informed, patient-centered clinical decisions improve care for the individual member and for the health care system as a whole. Our reviewers are practicing physicians across multiple specialties, and we are known for review quality, 100% turnaround-time compliance, and responsiveness to our health plan partners.

The Role

JMS is expanding its behavioral health reviewer panel and seeking board-certified Psychiatrists and Child & Adolescent Psychiatrists to serve as independent contractor Medical Directors. Medical Directors make medical necessity determinations on behavioral health cases for health plan members. They apply nationally recognized criteria and sound clinical judgment, and they document clear, defensible rationales.

This is a remote, 1099 independent contractor position. Both part-time and full-time hours are available, so the role can supplement an active clinical practice or serve as your primary professional commitment.

Responsibilities

Perform behavioral health medical necessity reviews, including prior authorization and concurrent review across inpatient, residential, partial hospitalization, intensive outpatient, and outpatient levels of care
Conduct first- and second-level appeal reviews with thorough, well-supported written determinations
Conduct peer-to-peer discussions with treating providers
Apply nationally recognized criteria, including MCG®, LOCUS, and CALOCUS, along with health plan medical policies, consistently and accurately
Meet all regulatory, accreditation, and contractual turnaround-time requirements
Meet Service Level Agreement metrics and performance guarantees

Required Qualifications

MD or DO
Current board certification in Adult Psychiatry and/or Child & Adolescent Psychiatry (ABPN or AOBNP)
Minimum of 3 years of direct clinical patient care experience after residency or fellowship
At least one current, unrestricted US medical license
US-based, with availability during standard business hours for case work and peer-to-peer calls
Excellent verbal and written communication skills

Preferred Qualifications

Active medical licenses in multiple states
Managed care, utilization management, or peer review experience (we train strong clinicians who are new to utilization management)
Experience applying MCG®, LOCUS, and/or CALOCUS criteria
Experience with Medicare, Medicaid, and Dual Special Needs Plan (D-SNP) populations
Familiarity with Transcranial Magnetic Stimulation (TMS) and Applied Behavior Analysis (ABA) service reviews

Compensation and Benefits

Compensation up to $300+/hr, paid per review
Part-time and full-time hours available
100% remote

To Apply

Apply through LinkedIn with your CV. Please list your board certification(s) and every state where you hold an active medical license.

This is an independent contractor (1099) position.

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