Physician Advisor, Utilization & Denials

Kingman Healthcare; Kingman (AZ); On-site; USD 140,000 - 190,000; Full time

Job summary

Kingman Healthcare is seeking a Physician Advisor to lead medical necessity reviews and support utilization management across the system. The role involves collaborating with hospital leadership, medical staff, and administration to ensure compliant documentation and standardized practices. Qualifications include MD/DO, residency, and board certification.

Arizona license must be active and unrestricted. Reports to the Director and is exempt, with a focus on improving care quality and patient

Qualifications

• MD/DO degree from an accredited medical school and completion of an accredited residency program.
• Board certification in specialty required at time of hire.
• Active and unrestricted state of Arizona medical license.

Responsibilities

• Perform timely and compliant medical necessity reviews with clear documentation for regulatory requirements.
• Facilitate denials management and assist with appeals letters.
• Collaborate with hospital leadership and medical staff to support utilization management initiatives.
• Standardize best practices in utilization management and care progression with leadership and administration.
• Review medical necessity of admission, continued stay, discharge planning, and care quality.

Skills

CMS regulatory knowledge

Clinical documentation integrity

InterQual/MCG familiarity

Education

MD/DO from accredited medical school

Completed accredited residency

Job description

Kingman Healthcare is seeking a Physician Advisor to lead medical necessity reviews and support utilization management across the system. The role involves collaborating with hospital leadership, medical staff, and administration to ensure compliant documentation and standardized practices. Qualifications include MD/DO, residency, and board certification.

Arizona license must be active and unrestricted. Reports to the Director and is exempt, with a focus on improving care quality and patient