Transform Healthcare as a Remote Physician Advisor - Utilization Management

Remote Full-time
Join our innovative team and drive success in a remote-based position, offering a competitive salary package and opportunities for growth and development. As a skilled and motivated Physician Advisor, you will provide medical leadership, ensure compliance with regulatory guidelines, and contribute to the strategic plans of our organization. With a strong focus on teamwork, quality improvement, and patient care, this part-time role is ideal for a dedicated professional seeking a challenging and rewarding experience.
Job Summary:
As a Physician Advisor - Utilization Management, you will play a crucial role in our team, providing medical expertise, guiding utilization management activities, and promoting professional development of our staff. Your responsibilities will include:

Participating in peer-to-peer discussions with medical directors and providing subject matter expert guidance on utilization management activities
Collaborating with IT to ensure logical processes, best practices, and compliance with CMS regulations
Promoting professional development of UM staff, focusing on compliant patient status assignments and consistent use of primary screening criteria
Working with Revenue Integrity to reduce denial and appeal burdens and increase revenue
Assisting with development and driving improvement initiatives, including providing feedback to medical staff and serving on strategic committees

Requirements:

Minimum 5 years of clinical practice in field of specialty or previous work as a Physician Advisor
M.D. or D.O. degree, completion of an approved residency and fellowship program (if applicable)
Licensed to practice in the State of Tennessee
Board Certification in practice specialty, with willingness to obtain CHCQM and CHCQM-PHYADV certifications

What We Offer:

Competitive salary package, commensurate with experience
Opportunities for growth and development in a dynamic and innovative organization
Remote-based position, offering flexibility and work-life balance
Collaborative and supportive team environment, focused on quality patient care and improvement

Apply Now and Take the First Step Towards a Rewarding Career:
Don't miss this exciting opportunity to join our team and make a meaningful impact in healthcare. Apply now and discover a career that offers challenge, growth, and fulfillment.
Apply Now

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