Physician Advisor: Utilization & Care Optimization

Allegheny Health Network; Pittsburgh (Allegheny County); On-site; USD 175,000 - 225,000; Full time

Job summary

Allegheny Health Network in Pittsburgh, PA is seeking a full-time Physician Advisor to optimize the use of healthcare services. This role involves level-of-care reviews, collaboration with a multidisciplinary team, and conducting peer discussions with payers. Candidates should have at least 5 years of clinical practice experience, an MD or DO degree, and board certification in any medical specialty. Benefits include participation in quality initiatives and opportunities for education within the healthcare team.

Qualifications

• 5 years of clinical practice experience in a hospital setting.
• Must be licensed in the state of Pennsylvania prior to employment.

Responsibilities

• Ensure appropriate use of healthcare services for patients.
• Collaborate with interdisciplinary care team including physicians and case managers.
• Discuss cases with insurance company medical directors for authorization.

Skills

Clinical practice experience

Medical necessity evaluation

Interdisciplinary collaboration

Peer-to-peer discussions

Education

Doctor of Medicine (MD) or Doctor of Osteopathy (DO)

Board certification in any medical subspecialty

Job description

Allegheny Health Network in Pittsburgh, PA is seeking a full-time Physician Advisor to optimize the use of healthcare services. This role involves level-of-care reviews, collaboration with a multidisciplinary team, and conducting peer discussions with payers. Candidates should have at least 5 years of clinical practice experience, an MD or DO degree, and board certification in any medical specialty. Benefits include participation in quality initiatives and opportunities for education within the healthcare team.