Physician Advisor: Utilization & Care Optimization

St. Joseph's Health; Paterson (NJ); On-site; USD 150,000 - 200,000; Full time

Job summary

A healthcare organization in New Jersey is seeking a Physician Advisor to oversee patient care and resource utilization. This role involves conducting medical necessity reviews, managing appeals, and collaborating with various stakeholders to enhance quality outcomes. The ideal candidate must possess strong clinical leadership skills and work primarily Monday to Friday, with potential weekend coverage. This position is crucial for ensuring compliance and optimizing patient throughput.

Responsibilities

• Conduct medical necessity and utilization reviews.
• Manage denials and appeals.
• Advise providers on patient status and documentation.
• Collaborate with Care Management and hospital leadership to improve throughput.

Job description

A healthcare organization in New Jersey is seeking a Physician Advisor to oversee patient care and resource utilization. This role involves conducting medical necessity reviews, managing appeals, and collaborating with various stakeholders to enhance quality outcomes. The ideal candidate must possess strong clinical leadership skills and work primarily Monday to Friday, with potential weekend coverage. This position is crucial for ensuring compliance and optimizing patient throughput.