Physician Advisor, Utilization & Clinical Strategy

Indiana University Health; Indiana; On-site; USD 150,000 - 210,000; Full time

Job summary

Indiana University Health is seeking a Physician Advisor to integrate clinical expertise with revenue cycle processes and ensure medical necessity reviews are aligned with policy and payer requirements.

You will liaise with IU Health Revenue Cycle Services, hospital administration, and clinical staff to optimize utilization, support authorizations and concurrent reviews, and mentor teammates while upholding confidentiality and HIPAA standards.

Qualifications

• Medical degree and board certification required.
• Current licensure to practice medicine.
• Clinical experience in a hospital setting.
• Understanding of clinical utilization review and healthcare regulations.
• Knowledge of current medical coding and billing practices.
• Excellent communication and interpersonal skills.
• Strong leadership abilities and a collaborative approach to problem-solving.

Responsibilities

• Acts as a liaison between IU Health Revenue Cycle Services, hospital administration, and clinical staff to optimize hospital services and medical necessity reviews.
• Provides clinical expertise and support to the Utilization Management team for authorizations, concurrent reviews, and payor denials.
• Connects to Promise by aligning with IU Health's mission and values to improve patient care and organizational performance.
• Demonstrates confidentiality and HIPAA compliance while handling sensitive patient information.
• Analyzes problems and opportunities to inform decisions and improve processes within the department.

Skills

Communication skills

Leadership

Collaboration

Critical thinking

Independent judgment

Problem solving

Education

Medical degree and board certification

Job description

Indiana University Health is seeking a Physician Advisor to integrate clinical expertise with revenue cycle processes and ensure medical necessity reviews are aligned with policy and payer requirements.

You will liaise with IU Health Revenue Cycle Services, hospital administration, and clinical staff to optimize utilization, support authorizations and concurrent reviews, and mentor teammates while upholding confidentiality and HIPAA standards.