Physician Advisor

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

📋 Description

• Provide leadership for the effective management of resources and utilization to ensure delivery of quality, cost-efficient care in the most suitable environment.

• Collaborate with medical staff leadership, medical team members, and resident physician house staff on resource and utilization management.

• Create and implement strategies to optimize the use of hospital services.

• Develop care management protocols in partnership with physicians and other stakeholders.

• Ensure that patients receive care at the appropriate level.

• Support enhancements in documentation, coding, and compliance.

• Conduct Peer to Peer reviews, Short Stay Reviews, and Extended Observation reviews.

• Provide education and training for medical staff.

• Prepare periodic reports for the Board, MEC, and Joint Conference.

• Make daily leadership decisions that drive results.

• Mentor and develop leaders and team members.

• Delegate authority and responsibilities while retaining accountability for outcomes.

• Lead teams towards achieving results through effective relationships and collaboration.

• Clearly and persuasively communicate information and ideas.

• Manage programs and projects from initiation through completion and implementation.

• Determine the status of hospitalized patients.

• Conduct peer-to-peer reviews with payors’ medical directors.

• Perform reviews of short inpatient stays.

• Daily review of observation patients.

• Foster relationships with medical staff and leadership concerning utilization management issues.

• Attend utilization management committees as a subject matter expert.

• Assist in handling denials and appeals.

• Educate medical staff on topics related to utilization management.

• Collaborate with UR nurses, IA staff, and Case Management to uphold and enhance the utilization management process.

• Monitor denial trends to help the team tackle new payor challenges.

⛳️ Requirements

• MD/DO Physician (REQUIRED)

• Must reside in and have authorization to work within the United States.

• Applications from candidates outside the United States will not be considered.

🏝️ Benefits

• Comprehensive healthcare benefits.

• Paid time off.

• Retirement benefits.

• Well-being programs.

• Professional certification relevant to the associate’s field.

• Tuition reimbursement.

• Quarterly incentive programs.

• Annual incentive programs.

• Work-life flexibility.

• Opportunities for professional development.