Psychiatry Physician General Psychiatrist - Physicians Only Apply - Perm
Company: Nneka Chinyere Anaebonam
Location: Baton Rouge
Posted on: October 24, 2024
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Job Description:
A Psychiatry Physician General Psychiatrist practice is seeking
a qualified physician for Baton Rouge, LA. This and other physician
jobs brought to you by ExactMD. Medical Doctors Only Apply.
Baton Rouge, LA - Medical Director - Psychiatry
Position Purpose: Assist the Chief Medical Director to direct and
coordinate the medical management, quality improvement and
credentialing functions for the business unit.
----- Provides medical leadership of all for utilization
management, cost containment, and medical quality improvement
activities. Performs medical review activities pertaining to
utilization review, quality assurance, and medical review of
complex, controversial, or experimental medical services. Supports
effective implementation of performance improvement initiatives for
capitated providers.
----- Assists Chief Medical Director in planning and establishing
goals and policies to improve quality and cost-effectiveness of
care and service for members. Provides medical expertise in the
operation of approved quality improvement and utilization
management programs in accordance with regulatory, state,
corporate, and accreditation requirements.
----- Assists the Chief Medical Director in the functioning of the
physician committees including committee structure, processes, and
membership. Oversees the activities of physician advisors. Utilizes
the services of medical and pharmacy consultants for reviewing
complex cases and medical necessity appeals. Participates in
provider network development and new market expansion as
appropriate. Assists in the development and implementation of
physician education with respect to clinical issues and
policies.
----- Identifies utilization review studies and evaluates adverse
trends in utilization of medical services, unusual provider
practice patterns, and adequacy of benefit/payment components.
Identifies clinical quality improvement studies to assist in
reducing unwarranted variation in clinical practice in order to
improve the quality and cost of care. Interfaces with physicians
and other providers in order to facilitate implementation of
recommendations to providers that would improve utilization and
health care quality. Reviews claims involving complex,
controversial, or unusual or new services in order to determine
medical necessity and appropriate payment.
----- Develops alliances with the provider community through the
development and implementation of the medical management programs.
As needed, may represent the business unit before various publics
both locally and nationally on medical philosophy, policies, and
related issues. Represents the business unit at appropriate state
committees and other ad hoc committees
Education/Experience: Board certification by the American Board of
Psychiatry and Neurology. Current state medical license without
restrictions.
Keywords: Nneka Chinyere Anaebonam, Baton Rouge , Psychiatry Physician General Psychiatrist - Physicians Only Apply - Perm, Healthcare , Baton Rouge, Louisiana
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