New Jersey Licensed Physician Advisor

To support optimal patient care, the part-time, remote New Jersey Licensed Physician Advisor will perform case reviews, provide clinical consultations, and ensure compliance with medical necessity and utilization management standards. Key responsibilities Conducts timely clinical reviews and consultations regarding medical necessity and continued stay for patients Maintains accountability for achieving case management outcomes and improving health record documentation Participates in ongoing training and mentoring of medical staff on payer requirements and utilization management practices 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 and familiarity with MCG/InterQual criteria preferred Strong analytical skills and proficiency in Microsoft Office Suite Ability to maintain an unrestricted medical license and Board Certification in good standing