Remote Physician Advisor: Utilization & Care Management

Ensemble Health Partners; Tallahassee (FL); Hybrid; USD 198,000 - 297,000; Full time

Job summary

Ensemble Health Partners is seeking a Physician Advisor to lead resource and utilization management across hospital services. You will work closely with medical staff leadership to optimize care, ensure appropriate levels of care, and support documentation, coding improvements and compliance.

The role includes Peer to Peer reviews, Short Stay Reviews, Extended Observation, and educating staff on UM topics. This position is remote with travel to client sites as needed.

Qualifications

• MD/DO physician with demonstrated ability to translate AI into business outcomes.
• Willingness to travel to client sites, temporary or corporate offices as required.
• Remote position with onsite work as business needs require.

Responsibilities

• Status determinations for hospitalized patients.
• Perform peer-to-peer reviews with payors’ medical directors.
• Short inpatient stay reviews.
• Review observation patients daily.
• Build relationships with medical staff and leadership for UM buy-in.
• Attend UM committees as subject matter expert.
• Educate medical staff on UM topics.
• Partner with UR nurses, IA staff, and Case Management to improve UM processes.
• Track denial trends to adapt to payor challenges.

Skills

AI in business outcomes

Education

MD/DO Physician

Job description

Ensemble Health Partners is seeking a Physician Advisor to lead resource and utilization management across hospital services. You will work closely with medical staff leadership to optimize care, ensure appropriate levels of care, and support documentation, coding improvements and compliance.

The role includes Peer to Peer reviews, Short Stay Reviews, Extended Observation, and educating staff on UM topics. This position is remote with travel to client sites as needed.