Physician Advisor Lead

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

📋 Description

• Deliver clinical leadership, mentorship, and daily support to HURC Physician Advisors.

• Maintain an active workload while fulfilling Physician Advisor responsibilities on designated client accounts.

• Act as a senior clinical resource for complex, high-priority, and escalated utilization review, medical necessity, and peer-to-peer (P2P) cases.

• Establish and promote consistent standards for clinical practices, documentation, communication, and client service.

• Conduct and oversee routine quality assessments and call audits for Physician Advisors.

• Monitor key performance indicators (KPIs) such as P2P completion, callback responsiveness, overturn rates, quality, timeliness, and client service.

• Identify performance trends and opportunities for coaching, education, and process enhancements.

• Collaborate with HR and Operations on reporting, management, and improvement initiatives related to performance.

• Assist with the onboarding, training, and continuous professional development of Physician Advisors.

• Develop and maintain educational resources, reference materials, and standardized best practices.

• Serve as a senior clinical resource for clients facing escalated clinical and operational challenges.

• Participate in client meetings, operational reviews, and clinical discussions as required.

• Analyze trends in denials, medical necessity determinations, payer behavior, and utilization management practices.

• Work with HURC leadership to formulate clinical recommendations, enhance workflows, and expand Physician Advisor services and specialized clinical programs.

• Contribute to the ongoing development and standardization of HURC's Physician Advisor program.

⛳️ Requirements

• Active, unrestricted U.S. physician license.

• Board certification in an appropriate medical specialty.

• Extensive experience as a Physician Advisor, including maintaining an active production workload.

• Strong background in utilization management, hospital medicine, healthcare revenue cycle, or a similar clinical environment.

• Proven expertise in P2P reviews, medical necessity determinations, inpatient admission criteria, continued stay reviews, denials, appeals, and payer processes.

• Experience in managing complex clinical cases and conducting negotiations between payers and providers.

• Exceptional written and verbal communication, negotiation, and collaboration skills.

• Ability to operate effectively in a remote, client-facing setting while meeting clinical leadership, production, quality, timeliness, and client service standards.

• Experience in mentoring, coaching, or leading physicians is preferred.

• Familiarity with Epic or other major electronic health record (EHR) platforms is preferred.

🏝️ Benefits

• Remote work arrangement.

• Professional development opportunities through onboarding, training, coaching, and ongoing development.

• Travel as required.