Remote Physician Advisor - Payer Peer-to-Peer

R1 RCM, Inc.; Florida; Remote; USD 150,000 - 199,000; Full time

Benefits offered by this job

Competitive benefits package

Job summary

R1 RCM, Inc. is seeking a Physician Advisor to help client facilities navigate compliant revenue and review payor cases.

You will evaluate denied authorizations, ensure documentation supports admission status, procedure, and care setting, and advise clients with medical directors from payor side. This remote US-based role requires active MD/DO licensure, 3+ years clinical experience, and strong clinical knowledge.

Qualifications

• Active, unrestricted MD or DO medical licensure.
• Minimum 3+ years of clinical experience post-residency completion.

Responsibilities

• Addresses the following issues: authorization requested, documentation support or lack of support for that authorization, evidence-based criteria for that support, and complex clinical evaluation of the request as a whole.
• Must work during pre-scheduled hours to be highly successful in this role (schedules are created about 30 days in advance).
• Physicians should be highly capable of working independently with a high level of performance in a rapidly changing, fast-paced environment.
• Successful physicians will need to meet quality and productivity standards.
• Actively engage with attending physicians to discuss appropriate status as supported by documentation.
• Make phone contact with utilization review team and/or case managers at client hospitals regarding submitted case determinations.
• Provide written analysis of the case and perform case reviews across multiple specialties

Skills

MD or DO license

Clinical experience 3+ years

Job description

R1 RCM, Inc. is seeking a Physician Advisor to help client facilities navigate compliant revenue and review payor cases.

You will evaluate denied authorizations, ensure documentation supports admission status, procedure, and care setting, and advise clients with medical directors from payor side. This remote US-based role requires active MD/DO licensure, 3+ years clinical experience, and strong clinical knowledge.