Texas Licensed Physician Advisor

A company is looking for a Physician Advisor.

Key Responsibilities

Conducts medical record reviews for medical necessity of hospital admissions and continued stays

Communicates with case management and attending physicians regarding clinical aspects and medical necessity of care

Engages in Peer to Peer discussions with payers as needed

Required Qualifications

MD or DO required

Unrestricted license in Texas required

Minimum of 5 years of clinical practice required

Utilization management experience

In-depth knowledge of CMS regulations and the 2-midnight rule