State Licensed Physician Advisor

Job Summary

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

Key Responsibilities

• Conducts clinical reviews for medical necessity and provides consultation on complex clinical issues
• Maintains accountability for case management outcomes and supports clinical progression of patient care
• Participates in ongoing training and education related to Utilization Management and Care Management

Required Qualifications

• Board Certified and licensed to practice medicine in the US or 3+ years active clinical experience in the US
• 3+ years experience as a Physician Advisor performing Level of Care and Peer to Peer Reviews
• Basic technical skills with Hospital EMRs, Microsoft Office, and Teams
• Knowledge and experience in utilization management, quality improvement, and patient safety
• Familiarity with MCG/InterQual criteria preferred