Pediatric Utilization Review Physician Advisor

CO010 Memorial Healthcare System; United States; On-site; USD 150,000 - 230,000; Full time

Job summary

Memorial Healthcare System in Fort Lauderdale, FL, seeks a physician to lead and improve utilization review and documentation processes. You will collaborate with the Medical Director of Centralized UR/HIM, assess medical necessity, and make decisions on admissions and continued stay.

The role requires at least 1 year of clinical experience, MD degree, Florida licenses, and you will conduct audits and educate staff to ensure compliant documentation and utilization practices.

Qualifications

• MD degree from an accredited medical school.
• Florida medical licenses (MD and/or DO) required.
• Minimum of 1 year of clinical work experience.

Responsibilities

• Collaborate with the Medical Director of Centralized UR/HIM and medical staff to improve utilization and documentation.
• Decide on referrals regarding pre-admission, authorization, medical necessity and admission/continued stay.
• Conduct peer-to-peer discussions with health plans as needed.
• Serve as a resource to medical staff for UR activities and educate on documentation benefits.

Skills

Utilization Review

Clinical Documentation

Medical Necessity

Peer Discussions

Education

Medical Doctor (MD)

Florida MD License (ME LICENSE)

Florida Osteopathic License (OS LICENSE)

Job description

Memorial Healthcare System in Fort Lauderdale, FL, seeks a physician to lead and improve utilization review and documentation processes. You will collaborate with the Medical Director of Centralized UR/HIM, assess medical necessity, and make decisions on admissions and continued stay.

The role requires at least 1 year of clinical experience, MD degree, Florida licenses, and you will conduct audits and educate staff to ensure compliant documentation and utilization practices.