Physician Advisor

About the role

This remote role (US‑based candidates only, no visa sponsorship) supports utilization management efforts and helps ensure appropriate inpatient status decisions for hospitalized patients. The Physician Advisor partners with medical directors, nurses, authorization staff, and other clinical stakeholders to strengthen denial management, compliance, and peer‑to‑peer review outcomes, and contributes to education and process improvement efforts that enhance utilization review performance across the organization.

Responsibilities

• Render status determinations for hospitalized patients
• Conduct peer‑to‑peer reviews with payors' medical directors
• Attend utilization management committees to provide expertise
• Assist with denial resolutions and appeals processes
• Educate medical staff on utilization management practices and compliance
• Collaborate with nurses and authorization staff to optimize UM processes
• Track and analyze denial trends to inform strategic initiatives

Qualifications

• MD or DO with board certification in a relevant specialty
• Minimum 5 years of clinical experience in a hospital setting
• Strong understanding of utilization management regulations and processes
• Exceptional communication skills for effective peer‑to‑peer interaction
• Experience managing and analyzing denial trends

Benefits

• Flexible work schedule to balance personal and professional life
• Opportunities for professional development and continuing education
• Supportive collaborative environment with access to experienced mentors
• Involvement in decision‑making processes within utilization management teams
• Comprehensive healthcare options to support personal well‑being

Pay

$200,000 – $250,000 annually