Physician Advisor - State Licensed

Job Summary

A company is looking for a Physician Advisor - Fully Remote.

Key Responsibilities

• Conducts clinical reviews and provides consultation on medical necessity and utilization management
• Maintains accountability for case management outcomes and supports clinical progression of patient care
• Facilitates training and education for physicians regarding payer requirements and documentation 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, Microsoft Office, and Teams
• Solid foundation in utilization management, quality improvement, and patient safety
• Familiarity with MCG/InterQual criteria preferred