Senior Physician Advisor & Utilization Lead

Med-Metrix; Philadelphia (Philadelphia County); Remote; USD 150,000 - 190,000; Full time

Job summary

Med-Metrix is seeking a Physician Advisor II to lead the physician advisor team, mentor staff, and ensure high-quality reviews and compliance across clients. You will work with medical staff leadership, case management, discharge planning, and utilization management to optimize hospital services and ensure appropriate levels of care.

The role requires board certification and a US medical license, 3+ years in a physician advisor or UR/UM role, and proficiency with EMRs and Microsoft Office.

Qualifications

• Licensed to practice medicine in the US.
• Board certification in relevant specialty.
• Experience as Physician Advisor or UR/UM Medical Director.
• Familiarity with utilization management concepts.

Responsibilities

• Respond to clinical review requests in a timely manner.
• Provide consultation on medical necessity and utilization management.
• Ensure compliance with criteria (MCG/InterQual).
• Mentor physicians and educate staff across facilities.
• Lead PAO dashboard management and reporting.

Skills

Interpersonal skills

Communication

Problem solving

Leadership

Mentoring

Team collaboration

Microsoft Office proficiency

Education

Medical license (US)

Board certification (ABQAURP)

ABQAURP sub-specialty certification

ACPA affiliation (preferred)

Tools

EMR systems

Microsoft Office

Job description

Med-Metrix is seeking a Physician Advisor II to lead the physician advisor team, mentor staff, and ensure high-quality reviews and compliance across clients. You will work with medical staff leadership, case management, discharge planning, and utilization management to optimize hospital services and ensure appropriate levels of care.

The role requires board certification and a US medical license, 3+ years in a physician advisor or UR/UM role, and proficiency with EMRs and Microsoft Office.