Texas Licensed Physician Advisor

Job Summary

A company is looking for a Physician Advisor to conduct clinical case reviews and provide recommendations regarding patient care.

Key Responsibilities

• Conducts medical record reviews for hospital admission necessity, discharge planning, and quality care management
• Communicates with case management and attending physicians about medical necessity and appropriate levels of care
• Engages in Peer to Peer discussions with payers as needed

Qualifications

• MD or DO required
• Unrestricted license in the state of Texas required
• Minimum of 5 years of clinical practice required
• Utilization management experience
• In-depth knowledge of CMS regulations and the 2-midnight rule