Part-time Onsite Physician Advisor - Join us and start doing your life's best work

Melrose, MA

full-time
Inpatient and outpatient

The Physician Advisor will work closely with the medical staff, including house staff, hospital leadership, and all utilization management (UM) personnel to develop and implement methods to optimize the use of hospital services.

Primary Responsibilities:

  • Conduct medical necessity reviews of cases referred by case management to ensure medical necessity and regulatory requirements are met for level of care
  • Meet with case management, social work, and other healthcare team members to discuss selected cases and make recommendations regarding patient status
  • Interact with medical staff and medical directors of third-party payers to discuss the needs of patients and alternative levels of care
  • Act as a consultant for the medical staff regarding their decisions for the appropriate level of care of hospitalized patients and supporting documentation
  • Participate in the claims denial process, including appeals
  • Review of utilization data to ensure hospital objectives for quality patient care
  • Act as a resource for the medical staff regarding federal, state, and payer regulatory, quality, and contract requirements
  • Serve as a physician member of the Utilization Review Committee, which may require non-clinical medical staff privileges application
  • Provide education on utilization management topics (e.g., documentation) to the medical and UM staffs

Physician Advisor Will Not:

  • Practice medicine during the hours scheduled, which includes:
  • Decision-making in a patient’s plan of care or discharge
  • Write orders or prescriptions
  • Provide on-call coverage
  • Set hospital clinical or administrative policies
  • Supervise house staff or hospital employees
  • Participate in any type of peer review (e.g., Quality, M&M)

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.


Posted March 5, 2021