Peer Reviewer - 1099 Consultant (Remote in WY)

Wyoming

State Health Solutions /

1099 Consultant /

Remote

As a Peer Reviewer -1099 Consultant, you will leverage your medical knowledge and deep understanding of mental health and substance abuse disorders, diagnosis, and standards of care to determine medical necessity and appropriate care for Medicaid beneficiaries.

We are looking for individuals located in Wyoming to join our team. You must either be located in the state of Wyoming or looking to relocate.

Essential Functions

Conduct critical peer reviews to ensure the healthcare given is appropriate and necessary. This role will focus on psychiatric and addiction medicine reviews.
Oversee and is responsible for the medical review activities for the assigned contract.
Serve as a technical expert on the peer review process.
Represent Telligen policies and procedures to medical and non-medical persons.
Participate in committee meetings as a representative of Telligen.

Requirements

Current unrestricted clinical license to practice medicine in the contracted state,or willingness to obtain licensure in the state
For WY Must be a Board-Certified Child/Adolescent Psychiatrist.
Current and active, unrestricted United States board certification by the American Board of Medical Specialties or Advisory Board of Osteopathic Medicine in Psychiatry/Neurology.
Certified Addiction Medicine Physicians are also highly desired.
Utilization Management experience.
Familiarity with MCG or InterQual medical necessity guidelines or ASAM criteria.
Board-Certified Child/Adolescent Psychiatrist preferred.

Commitment to Safety

As part of our commitment to health and safety, some roles may require additional health protocols (i.e. personal protective equipment or vaccination).

Who We Are:

Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.

Health has changed a lot through our 50-year history, but what has remained constant is that we care deeply about who we serve and what we do. Our success is built on our ability to adapt, respond to client needs, and offer innovative solutions.

Our business is our people and we’re looking for talented individuals who not only believe in our mission but who are ready to take ownership and make a difference in the lives of people, in the world of health. Learn more about who we are and what we do at www.telligen.com/about-us

Are you Ready?

We’re on a mission to transform lives and economies by improving health and getting there means following through on our values of Ownership, Community, Ingenuity & Integrity.

Ownership: As a 100% employee-owned company, our employee-owners drive our business, our solutions, and share in our success. When employee-owners grow and thrive, we all win.

Community: Putting others first and being a good corporate partner wherever we work, and play makes us who we are. We Show Up. For our clients, for our communities, and for each other.

Ingenuity: We’re a team of passionate professionals driven by hard work and big ideas. We understand that high-value breakthroughs come from taking calculated risks. If it will benefit our clients and advance our mission, we’re all ears. We celebrate free-thinking and challenge the status quo, so brainstorm away!

Integrity: Smiling faces (virtual or in-person) are the norm around here. We enjoy a friendly work environment where everyone is dedicated to mutual trust, respect, and excellence.

Thank you for your interest in Telligen!

Telligen and our affiliates are Affirmative Action, Equal Opportunity Employers, and E-Verify Participants.

Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time.

Telligen does not accept 3rd party solicitations from outside staffing firms.

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