Per Diem Physician Advisor

The Physician Advisor partners with clinical resource management nurses, attending physicians and hospital leadership to support appropriate utilization of healthcare resources and level-of-care decisions. Responsibilities include physician reviews, payer discussions, appeals support, regulatory compliance, physician education and quality improvement. Perform second-level physician reviews for level-of-care determinations and appropriate resource utilization. Respond to clinical resource management nurses' requests for physician review. Collaborate with attending physicians to resolve level-of-care questions and address resource utilization opportunities. Conduct peer-to-peer discussions with insurance payers and support appeals and denial management. Maintain knowledge of regulatory requirements, utilization management standards and payer guidelines. Educate physician colleagues and participate in quality improvement initiatives. Level-of-care determination Utilization management Clinical resource utilization review Payer coverage criteria Regulatory compliance Peer-to-peer payer discussions Appeals and denial management Patient data interpretation Financial and utilization report interpretation Physician education Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) Valid Connecticut physician license