Psychiatry Physician General Psychiatrist – Physicians Only Apply – Perm Position Available In East Baton Rouge, Louisiana

Job Description:

A Psychiatry Physician General Psychiatrist practice is seekinga qualified physician for Baton Rouge, LA. This and other physicianjobs brought to you by ExactMD. Medical Doctors Only Apply. Baton Rouge, LA

• Medical Director

• Psychiatry Position Purpose:

  Assist the Chief Medical Director to direct andcoordinate the medical management, quality improvement andcredentialing functions for the business unit.

• Provides medical leadership of all for utilizationmanagement, cost containment, and medical quality improvementactivities. Performs medical review activities pertaining toutilization review, quality assurance, and medical review ofcomplex, controversial, or experimental medical services. Supportseffective implementation of performance improvement initiatives forcapitated providers.
• Assists Chief Medical Director in planning and establishinggoals and policies to improve quality and cost-effectiveness ofcare and service for members. Provides medical expertise in theoperation of approved quality improvement and utilizationmanagement programs in accordance with regulatory, state,corporate, and accreditation requirements.
• Assists the Chief Medical Director in the functioning of thephysician committees including committee structure, processes, andmembership.

Oversees the activities of physician advisors. Utilizesthe services of medical and pharmacy consultants for reviewingcomplex cases and medical necessity appeals. Participates inprovider network development and new market expansion asappropriate. Assists in the development and implementation ofphysician education with respect to clinical issues andpolicies.

• Identifies utilization review studies and evaluates adversetrends in utilization of medical services, unusual providerpractice patterns, and adequacy of benefit/payment components.

Identifies clinical quality improvement studies to assist inreducing unwarranted variation in clinical practice in order toimprove the quality and cost of care. Interfaces with physiciansand other providers in order to facilitate implementation ofrecommendations to providers that would improve utilization andhealth care quality. Reviews claims involving complex,controversial, or unusual or new services in order to determinemedical necessity and appropriate payment.

• Develops alliances with the provider community through thedevelopment and implementation of the medical management programs.

As needed, may represent the business unit before various publicsboth locally and nationally on medical philosophy, policies, andrelated issues. Represents the business unit at appropriate statecommittees and other ad hoc committees

Education/Experience:

Board certification by the American Board ofPsychiatry and Neurology. Current state medical license withoutrestrictions.