PHYSICIAN ADVISOR-UTILIZATION MANAGEMENT

Job Summary:
The Physician Advisor serves as a liaison among physicians, Utilization Management (UM), Clinical Documentation Integrity (CDI), and hospital administration. This role involves advising on best practices, maintaining knowledge of payer rules and regulations, and ensuring compliance with hospital standards. Excellent customer service and a positive attitude are essential.

Responsibilities:
- Manage denial queues and conduct peer-to-peer conversations with payers.
- Perform medical necessity reviews and maintain work queues.
- Provide education to physicians and assist with CDI/UM processes.
- Collaborate with management on policy improvements and participate in educational initiatives.

Requirements:
- Medical degree and current Michigan medical license.
- Completion of a specialty residency and 3 years of hospital-based experience.
- Board certification preferred.

Skills:
- Strong relationship-building and communication skills.
- Proficiency in computer applications and healthcare reimbursement issues.

Working Conditions:
- Regular attendance and ability to perform physical tasks as needed.

Compensation:
- Pay range: $96.72 - $137.03 per hour with full-time benefits.