Inpatient Utilization Lead - Physician Advisor

Riverside Heathcare; Kankakee (IL); On-site; USD 131,395 - 194,324; Full time

Job summary

Riverside Healthcare is looking for a detail-oriented Physician Advisor to join our inpatient team in Kankakee, Illinois. In this full-time role, you will provide key clinical and operational leadership while ensuring compliance with regulatory standards. Your expertise will support effective utilization of healthcare services.

The position involves collaborating with medical leadership and managing documentation to optimize patient care services and reduce denials. This role includes rotating weekend call coverage.

Qualifications

• Minimum 5 years clinical experience in a hospital setting.
• Solid foundation in utilization management and hospital operations.

Responsibilities

• Assess and recommend levels of care for patients.
• Collaborate with teams to enhance documentation practices.
• Participate in denial management processes and appeals.
• Utilize InterQual, MCG, and other medical criteria.

Skills

Clinical judgment

Utilization management

Documentation improvement

Denial management

Team collaboration

Education

MD or DO

Unrestricted medical license in Illinois

Job description

Riverside Healthcare is looking for a detail-oriented Physician Advisor to join our inpatient team in Kankakee, Illinois. In this full-time role, you will provide key clinical and operational leadership while ensuring compliance with regulatory standards. Your expertise will support effective utilization of healthcare services.

The position involves collaborating with medical leadership and managing documentation to optimize patient care services and reduce denials. This role includes rotating weekend call coverage.