New York Licensed Physician Advisor

Job Summary

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

Key Responsibilities

• Conducts case reviews and provides consultation on clinical issues related to medical necessity and utilization management
• Maintains accountability for achieving case management outcomes and supports medical staff in patient care progression
• Participates in ongoing training and education related to the Physician Advisor role and ensures compliance with documentation standards

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
• Knowledge and experience in utilization management, quality improvement, and patient safety
• Familiarity with MCG/InterQual placement status criteria is preferred