Join CommonSpirit Health as a Utilization Management Physician Advisor to ensure effective healthcare service usage while collaborating with medical teams and third-party payers. Your expertise will drive quality patient care and compliance with regulatory standards.
Key Responsibilities
Conducts medical record review for medical necessity of hospital admission and quality care management
Communicates with case and utilization management teams regarding clinical aspects of hospital encounters
Conducts Peer to Peer discussions with payers as needed
Required Qualifications
MD or DO required
Unrestricted license in field of practice in the state of Texas required
Minimum of 5 years of clinical practice required
Preferred Qualifications
Minimum of 1 year of experience as a Physician Advisor preferred
Experience performing Peer to Peer Reviews, preferred