New Jersey Licensed Physician Advisor

Job Summary

To support optimal patient care, the fully remote New Jersey Licensed Physician Advisor will perform case reviews, provide clinical consultations, and ensure compliance with medical necessity standards while maintaining accountability for case management outcomes.

Key responsibilities

• Conducts clinical reviews for medical necessity and provides timely assistance to the Case Management department
• Consults with medical staff on complex clinical issues and advises on utilization management and continued stay justifications
• Maintains familiarity with standard criteria and participates in ongoing training related to the Physician Advisor role

Required qualifications

• Board Certified and licensed to practice medicine in the US or 3+ years of active clinical experience in the US
• 3+ years of experience as a Physician Advisor performing Level of Care and Peer to Peer Reviews
• Basic technical skills with Hospital EMRs
• Knowledge of utilization management, quality improvement, and patient safety
• Familiarity with MCG/InterQual placement status criteria is preferred