Inpatient Physician Advisor: Utilization & Collaboration Lead

MercyOne Medical Group; Des Moines (IA); On-site; USD 180,000 - 270,000; Full time

Benefits offered by this job

Paid malpractice

403(b) match

Performance incentives

Job summary

MercyOne Medical Group is seeking a dynamic, board-certified Physician Advisor with inpatient experience for an onsite role in Des Moines, IA. You will lead a physician-driven resource utilization program and collaborate with MercyOne leadership to design interventions, review cases for medical necessity, and serve as a resource on medical necessity and documentation.

The ideal candidate has strong CMS/commercial insurance knowledge and a team-building mindset to support better patient care.

Qualifications

• Board-certified physician with inpatient experience.
• Strong knowledge of CMS regulations and insurance processes.
• Experience serving on hospital committees or working knowledge of CMS/commercial insurance regulations.
• Collaborative, team-based decision making.

Responsibilities

• Lead physician-driven clinical resource utilization program with MercyOne Leadership team.
• Review cases to determine appropriate level of care based on medical necessity and apply regulatory guidelines.
• Serve as a resource for physicians regarding medical necessity, level of care, and clinical documentation.
• Foster effective communication between members of the care team.
• Establish and maintain peer-to-peer protocol.

Skills

Board-certified physician

Inpatient experience

CMS knowledge

Collaborative mindset

Job description

MercyOne Medical Group is seeking a dynamic, board-certified Physician Advisor with inpatient experience for an onsite role in Des Moines, IA. You will lead a physician-driven resource utilization program and collaborate with MercyOne leadership to design interventions, review cases for medical necessity, and serve as a resource on medical necessity and documentation.

The ideal candidate has strong CMS/commercial insurance knowledge and a team-building mindset to support better patient care.