New Jersey Licensed Physician Advisor

Job Summary

To support optimal patient care, the part-time, remote New Jersey Licensed Physician Advisor will perform case reviews, provide clinical consultations, and ensure compliance with medical necessity and utilization management standards.

Key responsibilities

• Conducts timely clinical reviews and consultations regarding medical necessity and continued stay for patients
• Maintains accountability for achieving case management outcomes and improving health record documentation
• Participates in ongoing training and mentoring of medical staff on payer requirements and utilization management practices

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 and familiarity with MCG/InterQual criteria preferred
• Strong analytical skills and proficiency in Microsoft Office Suite
• Ability to maintain an unrestricted medical license and Board Certification in good standing