Physician Advisor – 7 on 7 Off

This is a fully remote position, open to applicants in Florida.

📋 Description

• Lead quality performance initiatives throughout the organization by engaging with hospital physicians, utilization management, case management, clinical documentation improvement (CDI), denials, and quality personnel.

• Conduct case evaluations to ensure adherence to compliance, precise clinical documentation, and suitable utilization of healthcare services.

• Collaborate with hospital staff and medical professionals to provide education and expertise.

• Advise attending physicians regarding patient conditions, resource utilization, ongoing hospitalization, compliance issues, and quality tracking/reporting.

• Engage with third-party payer medical directors concerning medical necessity, resource utilization, and levels of care.

• Review medical records flagged by the utilization management (UM) team or healthcare team.

• Execute status determinations, second-level reviews, and continued-stay assessments.

• Analyze Code 44 cases and assist in managing length-of-stay effectively.

• Collaborate with case management and interdisciplinary teams to ensure seamless continuity of care and minimize readmission rates.

• Communicate with medical staff via secure email, secure text messaging, phone calls, and in-person meetings.

• Serve as a liaison between Utilization Management/Case Management and providers regarding suitable care plans.

• Assess and recommend enhancements related to resource allocation.

• Enhance coordination-of-care processes.

• Guide emergency department physicians and UM/CM teams on alternatives to acute care.

• Review denials and prepare appeal letters.

• Conduct peer-to-peer reviews with payers.

• Coordinate with payers to streamline approvals and avert denials or carved-out days.

• Undertake additional responsibilities as assigned.

• Operate independently in an office-style setting, engaging in reading, typing, and computer-related tasks.

⛳️ Requirements

• Must be an experienced Physician Advisor; no part-time applicants will be considered.

• MD or DO degree required.

• Must possess a current, unrestricted medical license in the state of residence.

• Proven ability to establish rapport with medical personnel and hospital leadership.

• Proficient in computer skills and familiar with electronic medical records (EMRs).

• 1–3 years of experience as a Physician Advisor along with clinical experience in a hospital environment.

• Board Certification / Eligibility is preferred.

• CCDS or CDIP certification is preferred.

• CCS certification is preferred.

• CHCQM certification (ABQAURP) is preferred.

• Strong interpersonal abilities.

• Exceptional written and verbal communication skills.

• Ability to work autonomously.

• Capacity to foster relationships with key members of the hospital team.

• Capability to perform tasks that may involve physical activity, including lifting up to 25 pounds.

• May be exposed to environmental hazards associated with healthcare and office work.

🏝️ Benefits

• Comprehensive health benefits package.

• Opportunities for professional development and advancement.

• Supportive work environment with a focus on collaboration.