Physician Advisor, Peer to Peer

This is a fully remote position, open to applicants in Alabama, +7 more states.

📋 Description

• Assess payor peer-to-peer cases where authorization has been declined

• Determine if appropriate documentation substantiates the requested admission status, procedure, and care environment

• Counsel client facilities on the suitability of requests based on the provided documentation

• Engage in discussions with medical directors on the payor side regarding cases

• Tackle authorization requests, documentation support, evidence-based standards, and complicated clinical evaluations

• Review and reply to payors and clients promptly

• Communicate with payor medical directors about authorization status backed by documentation

• Deliver written analyses of cases and conduct reviews across various specialties

• Act as a clinical resource for medical and case management personnel

• Identify, facilitate, and resolve issues related to documentation and utilization

⛳️ Requirements

• Active and unrestricted MD or DO medical license

• At least 3 years of clinical experience following the completion of residency

• Strong clinical expertise across diverse clinical areas

• Ability to operate independently while maintaining high performance in a dynamic and fast-paced environment

• Proficiency in fundamental computer skills

• Capability for written analysis and case reviews across multiple specialties

🏝️ Benefits

• Annual bonus plan with a target of 10.00%

• Competitive benefits package

• Continuous learning opportunities, collaboration across teams, and the chance to explore new career paths

• Meaningful work that contributes to communities served globally

• Reasonable accommodation assistance for applicants with disabilities