PA Licensed Physician Advisor

Job Summary

To support the corporate utilization management team, the full-time PA Licensed Physician Advisor will provide clinical oversight, conduct medical necessity reviews, and collaborate with interdisciplinary partners to enhance patient care and operational efficiency in a remote setting.

Key responsibilities

• Provide clinical consultation on admission status, level of care, and compliance with regulatory and payer requirements
• Conduct secondary reviews and participate in peer-to-peer discussions to resolve complex cases and promote consistent decision-making
• Educate medical staff on documentation standards and utilization practices while collaborating with various departments to improve patient flow and reimbursement accuracy

Required qualifications

• Must be a PA State Licensed Medical Doctor or Doctor of Osteopathic Medicine
• MD or DO is required
• 5+ years of clinical experience in a hospital setting is required
• 3+ years of knowledge in information technology, including statistical analysis and electronic medical record documentation
• Solid foundation in utilization management and hospital operations is required