Remote Physician Advisor – Payor Case Reviews

R1 RCM Holdco Inc.; United States; Remote; USD 150,000 - 199,000; Full time

Benefits offered by this job

Annual bonus

Job summary

R1 RCM Inc. is seeking a Physician Advisor to support client facilities by reviewing payor peer-to-peer cases and denials, ensuring documentation supports admission status, procedure, and care setting.

You will discuss cases with payor medical directors and provide written analyses across multiple specialties. This remote role requires strong clinical knowledge and independent performance in a fast-paced environment.

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/DO licensure

Clinical experience

Education

MD/DO degree

Job description

R1 RCM Inc. is seeking a Physician Advisor to support client facilities by reviewing payor peer-to-peer cases and denials, ensuring documentation supports admission status, procedure, and care setting.

You will discuss cases with payor medical directors and provide written analyses across multiple specialties. This remote role requires strong clinical knowledge and independent performance in a fast-paced environment.