Physician Medical Reviewer - PRN - On-site (Topeka, KS)

Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

• Provide clinical guidance for all aspects of the program's medical decision-making.
• Respond to and manage inquiries from physicians, providers, and clients, offering clinical evaluation and direction as needed.
• Stay informed on relevant national, state, and local healthcare regulations and legislation.
• Ensure compliance with all applicable regulatory and accreditation standards.
• Participate in contract-specific activities, such as Fair Hearings and other regulatory processes.
• Collaborate with medical, nursing, and administrative teams to address shared concerns and priorities.
• Facilitate effective communication between internal staff and external stakeholders.
• Perform additional duties as assigned.
• Read, understand, and adhere to all corporate policies, including polices related to HIPAA and its Privacy and Security Rules.

This role is contingent upon being awarded a contract. Start dates and final offers are contingent upon the contract award and final contract start dates.

Required Qualifications/Experience:

• Medical degree (M.D. or D.O.) with an active, unrestricted license to practice medicine issued by a recognized Board of Medical Examiners.
• Board certification in a recognized clinical specialty.
• Must hold a current medical license in Kansas as required by contractual obligations.
• Must reside in the state of Kansas within 5 miles of Topeka, Kansas.
• 5+ years of active clinical practice experience.
• 5+ years of experience with a strong track record in enhancing quality and utilization management programs.

• 10+ years of active clinical practice experience.
• Proven expertise in quality assurance and utilization review.
• A forward-thinking clinician with a strong understanding of current trends in healthcare and managed care.
• Demonstrated ability to collaborate effectively with diverse teams, showing approachability, respect, and strong consensus-building skills.
• Highly adaptable in fast-paced evolving environments, with a consistent track record of managing shifting priorities and emerging challenges.

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Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Thank You!

We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra Health

EEO AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

"Based on our compensation philosophy, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level."