Physician Advisor

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

📋 Description

• Conduct comprehensive case reviews across all case types to ensure maximum compliance.

• Collaborate with medical leadership, physicians, resident doctors, resource management, case management, social services, discharge planning, and utilization management.

• Propose strategies to enhance hospital service utilization, reduce length of stay, manage resources efficiently, and determine appropriate levels of care.

• Quickly respond to clinical review assistance requests from the Case Management team.

• Consult with attending physicians, nurses, and case management personnel on intricate clinical matters, continued-stay justifications, medical necessity, and utilization management.

• Utilize MCG/InterQual criteria along with professional judgment and patient-specific factors.

• Support case management outcomes and the clinical advancement of patient care.

• Enhance health record documentation that impacts ICD code assignments, severity, acuity, risk of mortality, and DRG assignments.

• Engage in training for Physician Advisor, Utilization Management, Care Management, and related areas.

• Achieve productivity, quality, and performance benchmarks.

• Uphold confidentiality and adhere to HIPAA and information security regulations.

• Educate and mentor physicians about payer requirements.

• Attend meetings as called by PAOC leadership.

• Partake in peer review processes when necessary or requested.

• Maintain medical licensure and board certification in good standing.

• Perform additional duties as assigned.

⛳️ Requirements

• Board Certified and licensed to practice medicine in the United States or possess 3+ years of active clinical experience in the US.

• A minimum of 3 years' experience as a Physician Advisor conducting Level of Care and Peer-to-Peer Reviews.

• Must hold and maintain an unrestricted medical license and Board Certification.

• Basic proficiency in Hospital EMRs is required.

• Foundational knowledge and/or experience in utilization management, quality enhancement, and patient safety.

• Familiarity with hospital organization, case management operations, and administrative standards and policies.

• Preferred familiarity with MCG/InterQual placement status criteria.

• Membership in the American College of Physician Advisors is preferred.

• ABQAURP Board Certification is preferred.

• ABQAURP Physician Advisor Sub-Specialty Certification is preferred.

• Proficiency in Microsoft Office Suite is necessary.

• Strong analytical, interpersonal, problem-solving, creative, written, and verbal communication skills.

• Capacity to present information effectively and exercise sound judgment.

• High integrity and reliability, with a strong sense of urgency and results orientation.

• Minimum availability of 16 shifts per month, with each shift lasting 6–8 hours, including 2 weekend shifts per month.

• A smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes.

• Ability to follow instructions, collaborate with others, and manage stress effectively.

🏝️ Benefits

• Continuous training and education related to the Physician Advisor position.

• Mandatory orientation and training.

• Option for remote work arrangements.

• Flexibility to work scheduled shifts, including 2 weekend shifts per month.