Insurance Job pay?

[finalpsychyear]

Curious what if any folks know about the positions $$ where docs work for private ins. companies from home and are the ones who deny or allow admissions and such essentially a little bit of pre auth work in addition to quality related work.

I was told typically these are filled internally and dont usually get posted. I am in a unique position that due to being on a committee for quality control I am likely to be approached about this role that a previous is leaving due to medical issues.

Do these pay at least what a regular veteran psych at 10 years would be expected to make? I do get that they are not having you see patients so some may still prefer it for the same pay range but others are telling me its generally above the normal pay due to the nature of the work not being very fulfilling and sorta working for the bad guys?

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[Stagg737]

I don’t know the pay rates, but the docs I worked with who were in those positions (ie, the docs calling me to find out why patients were still admitted) had a wide range from very reasonable and looking out for patients to denying everyone for everything. I found that when coverage was denied it was usually because documentation was lacking justification. Even the few times it was a social admit when I said something like “continue admission for 2 more days for direct admission to inpatient substance rehab to prevent further psych/medical readmission” got covered. Most of the time when it was denied, it was because the patient had truly just become a rock and we were stuck without a safe dispo plan and patient also didn’t really need acute admission anymore.

Certainly some docs are just lackeys for those companies, but I was surprised by how many really did try and make sure patients were covered when it was reasonable.

 

[Merovinge]

I don’t know the pay rates, but the docs I worked with who were in those positions (ie, the docs calling me to find out why patients were still admitted) had a wide range from very reasonable and looking out for patients to denying everyone for everything. I found that when coverage was denied it was usually because documentation was lacking justification. Even the few times it was a social admit when I said something like “continue admission for 2 more days for direct admission to inpatient substance rehab to prevent further psych/medical readmission” got covered. Most of the time when it was denied, it was because the patient had truly just become a rock and we were stuck without a safe dispo plan and patient also didn’t really need acute admission anymore.

Certainly some docs are just lackeys for those companies, but I was surprised by how many really did try and make sure patients were covered when it was reasonable.

Wow, that's absolutely wild and not at all my experience. I almost wouldn't believe a practicing attending psychiatrist in the US who does not work for an insurance company would publish that. Doing near daily P2Ps for suicidial kids needing more than 72 hours to stabilize was by far the worst part of IP work. People always say it's the parents, administration, or the complex trauma kids, but absolutely nothing was worse than dealing with insurance.

My current work in PHP/IOP is much better on the peer to peer frequency, but even then when they do go, they will deny the bulk of cases that get past our (excellent) UR team.

Everyone has their own journey in life, but if you make your several hundred thousands a year denying necessary care to our most marginalized populations in your pajamas, best of luck to you. I think some docs genuinely do try to do their best for patients, and they don't last at these jobs for more than a few months to maybe a year. The insurance company is absolutely tracking your denial rate very closely.

 

[the5thelement]

No clinical care + selling you soul to deny care = Unfulfilled life.

 

[FlowRate]

FWIW Physician UM roles in companies like Kaiser are not incentivized to just deny care. The goal really is to ensure that patients are meeting medical necessity criteria, which are usually reasonable and clearly defined. Especially when it comes to outpatient prescribing, there is likely a social good to this sort of work. There are far too many psychiatrists and NP's in the world who like to put their patients on whatever the hottest drug rep is giving them as samples that month.

 

[MedMan80]

I hated the subjectivity, some p2p docs were awesome, allow extra time and listen to me. Other's, like talking to a brick wall, although the clinical cases can be 100% the same..

 

[Merovinge]

FWIW Physician UM roles in companies like Kaiser are not incentivized to just deny care. The goal really is to ensure that patients are meeting medical necessity criteria, which are usually reasonable and clearly defined. Especially when it comes to outpatient prescribing, there is likely a social good to this sort of work. There are far too many psychiatrists and NP's in the world who like to put their patients on whatever the hottest drug rep is giving them as samples that month.

That's a significant minority of overall physician UM roles. I can absolutely appreciate that work, or the psych PharmD's who review all the psych meds rxed at a VA for example. But that is certainly like a single digit percentage of insurance UM roles, particularly with description of "private insurance company" in the OP posited question.