California Licensed Physician Advisor

Job Summary

California Licensed Physician Advisor works part-time as a 1099 contractor, providing clinical reviews and optimizing patient care in collaboration with healthcare teams while ensuring compliance with medical guidelines.

Key Responsibilities

• Conducts clinical reviews for medical necessity and treatment appropriateness in compliance with Medicare/CMS guidelines
• Acts as a liaison between medical staff and third-party payers to promote appropriate levels of medical care
• Oversees assigned staff and develops case management protocols while participating in quality management initiatives

Required Qualifications, Training, and Education

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