Physician Advisor II - PA Licensed

Job Summary

To support a growing Physician Advisor team, the full-time remote Physician Advisor II - PA Licensed will manage client relationships, perform case reviews, and mentor other advisors while ensuring compliance and quality of care across the spectrum of services.

Key responsibilities

• Conducts case reviews and provides consultation on medical necessity and utilization management to clinical staff
• Mentors and trains new and existing Physician Advisors to uphold quality standards and consistency in determinations
• Maintains accountability for achieving case management outcomes and supports documentation and coding improvements

Required qualifications

• Specialty Board Certified and licensed to practice medicine in the US
• 3+ years of experience as a Physician Advisor or in a similar role performing case reviews
• Basic technical skills with Hospital EMRs and proficiency in Microsoft Office and Teams
• Solid foundation in utilization management, quality improvement, and patient safety
• Familiarity with MCG/InterQual criteria is preferred