Physician Advisor

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

📋 Description

• Make compliant status determinations for patients admitted to the hospital.

• Perform peer-to-peer reviews with medical directors from payors.

• Act as a subject matter expert on issues related to utilization management.

• Daily review of short inpatient stays and observation patients.

• Foster relationships with medical personnel and leadership to advance utilization management initiatives.

• Participate in utilization management committees.

• Support the process of denials and appeals.

• Provide education to medical staff on topics related to utilization management.

• Collaborate with utilization review nurses, insurance authorization personnel, and Case Management to enhance utilization management processes.

• Monitor denial trends and assist the team in adapting to the changing challenges posed by payors.

⛳️ Requirements

• Physician role focused on utilization management and advisory responsibilities for physicians.

• Must live and be authorized to work in the United States.

• Applications from individuals outside the United States will not be accepted.

• Familiarity with issues related to utilization management.

• Capability to conduct peer-to-peer reviews with medical directors from payors.

• Ability to review short inpatient stays and observation patients.

• Skill in collaborating with utilization review nurses, insurance authorization staff, and Case Management.

• Capacity to attend utilization management committees.

• Ability to assist with denials and appeals processes.

• Expertise in educating medical staff on matters concerning utilization management.

• Competence in tracking denial trends and adjusting to the evolving challenges from payors.

🏝️ Benefits

• Comprehensive benefits package that includes healthcare, paid time off, retirement plans, and well-being programs.

• Professional certification relevant to the associate's area of expertise.

• Tuition reimbursement assistance.

• Incentive programs offered quarterly and annually for employees who exceed expectations.

• Flexibility in work-life balance.

• Opportunities for professional development.