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Pennsylvania Licensed Physician Advisor

workfromhome • Posted 6 days ago
Remote Full Time Healthcare Practitioners and Technical Occupations

Seeking a collaborative and experienced Pennsylvania Licensed Physician Advisor, this full-time remote position will manage utilization management and physician engagement to ensure high-quality, compliant patient care while partnering with hospital leadership and medical staff. Key Responsibilities Provide guidance on 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 and hospital leadership to improve documentation and resource utilization while ensuring compliance with regulations Required Qualifications Graduate of an accredited School of Medicine (Allopathic/Osteopathic) Possess or able to obtain an unrestricted PA Medical License Board Eligible or Board Certified Minimum 5 years' clinical experience in a hospital setting Solid foundation in utilization management and hospital operations

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