Physician Advisor

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

📋 Description

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

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

• Propose strategies to enhance hospital service utilization and patient care resource management.

• Identify opportunities for optimizing length of stay and ensuring the appropriate level of care.

• Assist in improving documentation, coding practices, and compliance.

• Oversee the proper utilization of diagnostic and therapeutic modalities.

• Address clinical review requests regarding medical necessity and other case management requirements.

• Counsel attendings, nurses, and case management personnel on intricate clinical issues, continued-stay justification, medical necessity, and utilization management.

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

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

• Enhance health record documentation impacting ICD code capture, severity, acuity, risk of mortality, and DRG classification.

• Engage in training, education, meetings, and peer review processes.

• Facilitate, mentor, and educate physicians concerning payer requirements.

• Achieve productivity, quality, and performance targets.

• Uphold patient and business confidentiality while safeguarding PHI in line with HIPAA regulations.

• Execute additional duties as assigned.

⛳️ Requirements

• Must be board certified and licensed to practice medicine in the US, or possess 3+ years of active clinical experience in the US.

• At least 3 years of experience as a Physician Advisor conducting Level of Care reviews and Peer-to-Peer assessments.

• Must hold an unrestricted medical license and Board Certification.

• Strong foundation, knowledge, and/or experience in utilization management, quality improvement, and patient safety.

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

• Basic technical skills with hospital EMRs are required.

• Preferred familiarity with MCG/InterQual placement status criteria.

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

• Board Certification by ABQAURP is preferred.

• Physician Advisor Sub-Specialty Certification by ABQAURP is preferred.

• Proficiency in Microsoft Office Suite is necessary.

• Excellent analytical, interpersonal, problem-solving, creative, written, and verbal communication abilities.

• Capability to present information effectively, collaborate, manage stress, exercise sound judgment, and make timely decisions.

• High integrity, dependability, urgency, and results-oriented mindset are essential.

• Must maintain medical licensure and board certification in good standing.

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

• Compliance with HIPAA and information security policies is mandatory.

🏝️ Benefits

• A minimum of 16 shifts per month, each shift lasting 6–8 hours, including 2 weekend shifts per month.

• Required allowance for a smartphone or electronic device for multifactor authentication and security purposes.