Physician Advisor

Join Hartford HealthCare – Integrated Care Partners (ICP) as a Per Diem Physician Advisor to provide vital leadership in utilization management and healthcare resource optimization. In this role, you will partner closely with Clinical Resource Management nurses, attending physicians, and hospital leadership to ensure appropriate level-of-care determinations and regulatory compliance. You will help shape the delivery of high-quality, patient-centered care across Connecticut's most comprehensive integrated health system.

Practice Info

• Integrated Care Partners (ICP) is Hartford HealthCare's physician-led clinically integrated network
• Role operates within the Clinical Resource Management team

Responsibilities

• Perform second-level physician reviews for level-of-care determinations and appropriate utilization of healthcare resources
• Respond promptly to requests from Clinical Resource Management nurses for physician review
• Collaborate with attending physicians to resolve level-of-care questions and address opportunities for appropriate resource utilization
• Conduct peer-to-peer discussions with insurance payers and provide support for appeals and denial management
• Maintain current knowledge of regulatory requirements, utilization management standards, and payer guidelines
• Educate physician colleagues on utilization management best practices and evolving regulatory trends
• Meet established Physician Advisor coverage requirements for assigned per diem shifts
• Participate in quality improvement initiatives and perform other duties as assigned

Shift & Schedule

• Per diem
• Days/time vary, including weekends and holidays

Requirements

• Doctor of Medicine or Doctor of Osteopathic Medicine
• Three to five years of acute experience
• Five years of relevant experience, acute care or managed care is preferred
• Valid State of CT Physician License
• Able to influence, negotiate and educate
• Ability to understand and interpret patient data, finance and utilization reports
• Understanding of government and payer coverage criteria and regulatory requirements