Remote Utilization Management Physician Advisor

CommonSpirit Health; Englewood (CO); On-site; USD 110,442 - 164,292; Full time

Job summary

CommonSpirit Health is seeking a System Physician Advisor to conduct clinical case reviews in a remote capacity. This role entails ensuring effective utilization of healthcare services, communicating with medical staff, and making recommendations regarding patient care.

The ideal candidate will hold an MD or DO with a minimum of 5 years of clinical practice and 1 year of experience as a Physician Advisor preferred. The position offers a competitive pay range of $80.17 - $119.26 per hour.

Qualifications

• MD or DO required.
• Unrestricted license in field of practice.
• Minimum of 1 year of experience as a Physician Advisor preferred.
• Minimum of 5 years of clinical practice required.

Responsibilities

• Conduct medical record review for medical necessity of hospital admission.
• Understand Medicare Inpatient Prospective Payment System (IPPS) intricacies.
• Make telephonic/electronic contacts with case management.
• Conduct Peer to Peer discussions with payers as needed.

Skills

MD or DO required

Experience as a Physician Advisor

Clinical practice

Knowledge of CMS regulations

Utilization management experience

Education

Unrestricted license in field of practice

Continuing medical education programs

Job description

CommonSpirit Health is seeking a System Physician Advisor to conduct clinical case reviews in a remote capacity. This role entails ensuring effective utilization of healthcare services, communicating with medical staff, and making recommendations regarding patient care.

The ideal candidate will hold an MD or DO with a minimum of 5 years of clinical practice and 1 year of experience as a Physician Advisor preferred. The position offers a competitive pay range of $80.17 - $119.26 per hour.