Physician Advisor, Utilization & Appeals

Xsolis; United States; On-site; USD 80,000 - 120,000; Full time

Job summary

Xsolis is seeking a Physician Advisor in the United States to provide concurrent review and appeal support services. The successful candidate will be responsible for clinical reviews according to regulatory requirements and will assist with level of care management and denial processes. A minimum of 5 years of recent clinical practice experience is required. Applicants should hold a medical degree and have knowledge in utilization management. This full-time position offers opportunities for professional development and requires occasional travel to training locations.

Qualifications

• 5 years recent experience in clinical practice as a physician.
• Utilization management experience preferred.
• Licensed physician without restrictions.

Responsibilities

• Provide clinical reviews according to Managed Care and CMS Regulatory Requirements.
• Assist with level of care and length of stay management on a case-by-case basis.
• Ensure appropriate documentation of patient care reviews, decisions, and pertinent information.
• Educate staff on regulatory requirements and utilization.

Skills

Utilization management

Verbal communication

Written communication

ICD coding knowledge

Computer skills

Education

Graduate of an accredited medical school

Education in quality and utilization management

Tools

MS Office Suite

Job description

Xsolis is seeking a Physician Advisor in the United States to provide concurrent review and appeal support services. The successful candidate will be responsible for clinical reviews according to regulatory requirements and will assist with level of care management and denial processes. A minimum of 5 years of recent clinical practice experience is required. Applicants should hold a medical degree and have knowledge in utilization management. This full-time position offers opportunities for professional development and requires occasional travel to training locations.