California Licensed Physician Advisor

Job Summary

A company is looking for a Physician Advisor (UM) - Part Time 1099 with a California License.

Key Responsibilities

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

Required Qualifications, Training, and Education

• Minimum of 3 years of experience in clinical care, quality management, utilization, and 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