California Licensed Physician Advisor

Job Summary

A company is looking for a Utilization Management Physician Advisor, CA Licensed (Part Time).

Key Responsibilities

• Processes second level reviews in compliance with Medicare/CMS guidelines for various levels of care
• Acts as a liaison between medical staff, utilization review, and third-party payers to promote appropriate medical care levels
• Collaborates with interdisciplinary teams to develop case management protocols and oversee training for NP's/PA's

Required Qualifications and Education

• Minimum of 3 years of experience in clinical care, quality management, utilization, or case management
• Completion of medical school and specialty residency, preferably in internal medicine
• Current, non-restricted licensure for clinical practice in California
• Experience as a Physician Advisor is preferred
• Board certification in a subspecialty or post-residency fellowship is preferred