New Jersey Licensed Physician Advisor

Job Summary

To support optimal patient care, the part-time New Jersey Licensed Physician Advisor will conduct case reviews, provide clinical consultations, and collaborate with medical staff remotely while ensuring compliance with utilization management standards.

Key responsibilities

• Conduct case reviews and respond to clinical review requests from the Case Management department
• Consult with medical staff on complex clinical issues and advise on medical necessity and utilization management
• Maintain accountability for achieving case management outcomes and support documentation and coding improvements

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
• Solid foundation in utilization management, quality improvement, and patient safety
• Familiarity with MCG/InterQual placement status criteria preferred