A company is looking for a Physician Advisor, Utilization Management.
Key Responsibilities
Process second level reviews in compliance with Medicare / CMS guidelines for various levels of care
Act as a liaison between medical staff, utilization review, and third-party payers to promote appropriate medical care levels
Oversee assigned staff, including recruiting, training, and evaluating performance
Required Qualifications
Minimum of 3 years of experience in clinical care, quality management, or utilization and case management
Completion of medical school and specialty residency, preferably in internal medicine
Current, non-restricted licensure for clinical practice in the state of California
Experience as a Physician Advisor is preferred
Board certification and subspecialty fellowship are preferred
Physician Physician • Raleigh, North Carolina, United States