Not specified; eligible for management incentive p...
Medical doctor or doctor of osteopathy degree
Current medical license required
5 years medical practice experience
This role serves as a pivotal Physician Advisor bridging clinical care with administrative requirements to optimize patient outcomes and resource utilization
Job Summary
This role serves as a pivotal Physician Advisor bridging clinical care with administrative requirements to optimize patient outcomes and resource utilization.
The position involves conducting secondary medical necessity reviews, denial reviews, and engaging in peer-to-peer conversations with insurance company medical directors.
Candidates will receive comprehensive training up to one month and have the option to participate in a Management Incentive Program as part of their total rewards package.
Matching Summary
This role serves as a pivotal Physician Advisor bridging clinical care with administrative requirements to optimize patient outcomes and resource utilization.
Salary
Not specified; Eligible for Management Incentive Program; Comprehensive health, financial, and security benefits included
Skills & Requirements
Must-have
Medical Doctor or Doctor of Osteopathy degree
Current medical license required
5 years medical practice experience
Knowledge of HMO operations and CMS regulations
Peer-to-peer conversation skills with insurance directors
Nice-to-have
Board Certification in relevant specialty
Experience with Dragonfly system documentation
Mentoring learners in teaching environment
Volunteer for holiday coverage flexibility
Strong presentation and stakeholder communication
Key Requirements
MD or DO degree
Current medical license
Board certification preferred
Health Care Quality and Management Certification within 3 years
5 years of medical practice experience
Knowledge of NCHQ standards and reimbursement models