Remote Physician Advisor - Utilization & Appeals Leader

Ensemble Health Partners; Columbus (OH); Remote; USD 198,000 - 297,000; Full time

Benefits offered by this job

Healthcare benefits

Tuition reimbursement

Recognition programs

Job summary

Ensemble Health Partners is seeking a Physician Advisor to render compliant status determinations for hospitalized patients, conduct peer-to-peer reviews with payors' medical directors, and serve as a subject matter expert on utilization management (UM) issues.

The role reviews short inpatient stays and observation patients daily while building strong relationships with medical staff and leadership to support UM initiatives.

Qualifications

• MD/DO Physician with demonstrated AI usage translating AI into business outcomes.
• Ability to move teams from experimentation to scale in a healthcare setting.

Responsibilities

• Status determinations for hospitalized patients.
• Perform peer-to-peer reviews with payors' medical directors.
• Short inpatient stay reviews and daily observation patient reviews.
• Build relationships with medical staff and leadership to gain support for UM initiatives.
• Attend UM committees and educate medical staff on UM topics.

Skills

MD/DO Physician

AI in Healthcare

Education

MD/DO Physician degree

Job description

Ensemble Health Partners is seeking a Physician Advisor to render compliant status determinations for hospitalized patients, conduct peer-to-peer reviews with payors' medical directors, and serve as a subject matter expert on utilization management (UM) issues.

The role reviews short inpatient stays and observation patients daily while building strong relationships with medical staff and leadership to support UM initiatives.