Beacon Health Strategies
Physician Advisor
Medical Affairs
JOB DESCRIPTION: The Beacon Physician Advisor (PA) is responsible for the review of clinical cases and questions regarding medical necessity, quality of care, length of stay determination and overall clinical practice. He/she may be the designee for the Medical Director, as needed. Supervisor/Report to the Vice President for Medical Affairs. This position is home based but must be Kentucky based.
PRIMARY RESPONSIBILITIES
1. Follow all pertinent Beacon policies and procedures, and specifically those related to authorization, clinical denials, modifications, reconsiderations and appeals
2. Conduct peer clinical review by telephone and/or in person, to provide opportunity for physician or other attending provider to discuss clinical information for purposes of initial determinations, or, in cases of non-authorization, for reconsiderations and/or appeals
3. Oversee specialty programs (child/adolescent, geriatric, addictions, etc.) as assigned.
4. Follow Beacon’s policies and procedures on Complaints and Incidents, as assigned.
5. Conduct retrospective chart review, as assigned
6. Participate in NCQA and URAC accreditation process, as assigned
7. Participate in designated Beacon Committees
EXPERIENCE/EDUCATION:
Current, valid and unrestricted medical KY license required, with proof on date of hire. Re-verification will take place no less than every 3 years.
Clinically active MD or DO with six years experience, board certified in psychiatry. Knowledge of managed care required; knowledge of community psychiatry, child psychiatry, public sector populations, forensic issues strongly preferred. Academic experience and strong research and/or teaching background helpful, but not required.
Interested candidates send CV/Resume to:
