Physician Advisor, Quality Utilization Management

Responsibilities

• Supporting care coordination
• Leading UM committees
• Educating staff on clinical documentation and medical necessity
• Promoting evidence-based practices
• Attending rounds
• Analyzing payer trends
• Managing denials
• Implementing process improvements aligned with regulatory standards

Qualifications

• A minimum of five years of clinical practice
• Strong leadership and communication skills
• Licensure as a licensed, board-certified physician
• Experience in utilization management
• Committee participation experience
• Membership in professional organizations (preferred)