Seeking a Pennsylvania Licensed Physician Advisor, this full-time remote position will manage utilization management and physician engagement to promote high-quality, efficient, and compliant patient care while collaborating with hospital leadership and medical staff. Key Responsibilities Provide guidance on appropriate patient status, medical necessity, and level of care, including secondary reviews and observation cases Support utilization review and denial management activities, including peer-to-peer discussions and appeals with third-party payers Collaborate with physicians, case management, and hospital leadership to improve documentation, care progression, and appropriate resource utilization Required Qualifications Graduate of an accredited School of Medicine (Allopathic/Osteopathic) Possess or able to obtain an unrestricted PA Medical License Board Certified or Board Eligible Minimum 5 years' clinical experience in a hospital setting Solid foundation in utilization management and hospital operations
Pennsylvania Licensed Physician Advisor in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.