Employee, Full-Time, Part-Time
Folsom, CA Candidates need to be able to work in the City or State specified – Telecommute
Princpl Cnslt – Medical (Psych-Child-Adol)
Job Locations: US-CA-Folsom
Requisition ID: 2019-39207
# of Openings: 1
Job Schedule: Regular Full-Time
MAXIMUS is a leading operator of government health and human services programs and has partnered with state, federal and local governments to provide critical, high quality health and human service programs to a diverse array of communities. Operating under MAXIMUS’s founding mission of Helping Government Serve the People? since 1975, MAXIMUS Federal Services is entirely focused on helping government agencies run programs cost-effectively and serve program constituents with improved outcomes. By being a responsible steward for government programs, we help the federal government deliver on its promises through our people, process and technology. Our focus is always on outcomes and results that connect citizens more effectively with government services.
The Principal Consultant – Medical staff member will provide evidence-based clinical reviews and apply appropriate authority to make determination on cases.
Essential Job Duties:
Complete a record review of all authorization requests for psychotropic medication for which a second opinion record review is requested by a county child welfare or probation agency to ensure the safe prescribing of psychotropic medications for dependents and wards of the juvenile court.
Functions as liaison to the medical community. Researches controversial medical procedures or technology
Clarifies utilization specifications, coding and medical necessity issues; May be required to educate providers, client clinical staff, or appellants on issues concerning medical policies
Provides citations to authorities as necessary
Disseminates complex medical information in a narrative understood by non-clinical personnel.
Utilizes electronic and hard copy tools to research issues
Be a resource for the staff for medical review; duties may include but not limited to: precertification, adjudication of appeals, care plan development, clinical panel medication review, research, development, and training for the medical review staff including quality feedback.
Performs other special projects not related to a specific case such as process improvement, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary
Demonstrates teamwork and promotes positive company relations by being an active listener.
Performs other duties as may be assigned by management
Education and Experience Requirements:
Doctor of Medicine or Osteopathy currently licensed in and meet all legal requirements for the practice of medicine in California as determined by the Medical Board of California or the Osteopathic Medical Board of California with Board certification in one of more specialties recognized by the ABMS (American Board of Medical Specialties) or AOBM (American Osteopathic Board of Medicine)
Have a current subspecialty certificate in Child and Adolescent Psychiatry by the American Board of Psychiatry and Neurology
5 years, post Board certification, experience in direct patient care required.
Three (3) years of experience working in the field of clinical psychiatry.
Have at least one (1) year of experience working with a state department or other federal or local government agencies.
Two (2) years of current knowledge and experience in treating children and youth in the child-welfare system
Active practice requirement of an average 20 hours per week part-time practice in the past two years, or full-time clinical practice in the previous 4 years required.
Ability to pass credentialing based upon URAC/NCQA type standards
Knowledge of medical review and utilization review preferred.
Enhances department and organization reputation by accepting ownership for accomplishing new and different requests; exploring oppo…
Healthcare Consultant , Medical & Health , Doctor & Practitioner , Mental Health , Youth & Children