KEPRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. KEPRO is seeking resumes for a highly experienced professional.
- Collaborates with senior management in the further development and execution of the Maine ASO - Behavioral Health Utilization Review Contract.
- Participates in Case Conferences with Providers to evaluate clinical needs.
- Available to providers for individual consultation of a case by case basis.
- Conducts periodic audits of provider work plans and progress toward goals to identify opportunities for improvement.
- Provides education on relevant clinical topics of interest to clinical reviewers.
- Completes Medical Director reviews and determinations on UM pre-cert and appeals requests as may be assigned during the Medical Director’s absence.
- Participate in activities specific to contractual arrangements as may be assigned.
- Minimal travel may be required to participate in KEPRO and DHHS Collaboration meetings.
- Other duties as assigned.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary from time to time.
- Psychiatrist - M.D. or D.O. with current non-restricted license to practice medicine by the Board of Medical Examiners.
- License must be in same state as contractually required.
- Board certification in the State of Maine in a clinical specialty is required.
Knowledge, Skills, Abilities
- Working knowledge of quality assurance, utilization review, and case management is required.
- Ability to work effectively with a diversity of personalities. Must be approachable; show respect for others, and a consensus builder.
- Adaptable with strong collaborative management style, a creative thinker with high energy and enthusiasm, and a team player who promotes the concepts of people working together.
- Able to adapt to frequently changing work parameters
- 10+ years of clinical practice.
- Prior review or case management experience or quality assurance committee responsibility in a hospital setting preferred.
Mental and Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.
KEPRO offers challenging careers, excellent benefits and opportunities for advancement. For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our website at www.KEPRO.com for more information on the KEPRO Family of Companies.
EOE AA M/F/Vet/Disability
KEPRO is an E-Verify employer. E-Verify is an internet based system operated by the Department of Homeland Security (DHS) in partnership with the Social Security Administration (SSA) that allows participating employers to electronically verify the employment eligibility of their newly hired employees in the United States.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information.