Remote Physician Advisor – Utilization Management

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

Benefits offered by this job

Tuition reimbursement

Remote-friendly environment

Job summary

Ensemble Health Partners is seeking a Physician Advisor to render compliant determinations for hospitalized patients and conduct peer-to-peer reviews with payors' medical directors. The role involves daily reviews of short stays and observations, building strong relationships with medical staff to support utilization management initiatives.

As a remote position with potential onsite travel to client locations, you will attend UM committees and educate staff on UM topics, collaborating with UR

Qualifications

• MD/DO physician with demonstrated advanced usage of AI.
• Experience translating AI into measurable business outcomes.
• Ability to move teams from experimentation to scale.

Responsibilities

• Render compliant status determinations for hospitalized patients.
• Perform peer-to-peer reviews with payors' medical directors.
• Review short inpatient stays and observation patients daily.
• Attend UM committees as subject matter expert and educate medical staff on UM topics.
• Partner with UR nurses, IA staff, and Case Management to improve UM processes.
• Track denial trends to help adapt to evolving payor challenges.

Skills

Advanced AI usage

AI to business outcomes

Education

MD/DO Physician

Job description

Ensemble Health Partners is seeking a Physician Advisor to render compliant determinations for hospitalized patients and conduct peer-to-peer reviews with payors' medical directors. The role involves daily reviews of short stays and observations, building strong relationships with medical staff to support utilization management initiatives.

As a remote position with potential onsite travel to client locations, you will attend UM committees and educate staff on UM topics, collaborating with UR