United States onlyThis position is posted by Jobgether on behalf of a partner company. We are currently looking for a System Physician Advisor in the United States.
As a System Physician Advisor, you will play a key role in ensuring high-quality, efficient patient care by providing expert clinical guidance across utilization management processes. You will review complex cases, collaborate with case management teams, and advise attending physicians on the appropriate level of care and clinical documentation. This role operates in a remote-friendly environment and requires a balance of clinical expertise, regulatory knowledge, and strong communication skills. You will help optimize patient outcomes while ensuring compliance with federal and state healthcare regulations. Your input will support decision-making for both patient care and healthcare resource management, making a meaningful impact on overall organizational effectiveness.
Accountabilities:
- Conduct medical record reviews to assess medical necessity, appropriateness of hospitalization, continued stay, and discharge planning.
- Collaborate remotely with case and utilization management teams to discuss patient care options and recommend the appropriate level of care.
- Communicate with attending physicians to advise on clinical decisions, documentation improvement, and adherence to governmental and commercial guidelines.
- Perform Peer-to-Peer reviews with payers as needed to support utilization management and reimbursement compliance.
- Act as a resource and consultant to medical staff regarding federal and state utilization, quality regulations, and best practices.
- Maintain clear, concise, and consistent communication with all stakeholders to support effective decision-making and patient care.
Requirements
- MD or DO degree with an unrestricted license in the state of Texas.
- Minimum of 5 years of clinical practice experience; at least 1 year preferred in a Physician Advisor role.
- Demonstrated knowledge and experience in utilization management, CMS regulations (including the 2-midnight rule), and hospital quality standards.
- Broad-based clinical knowledge with credibility and respect among medical staff physicians.
- Experience performing Peer-to-Peer reviews and collaborating with case management teams.
- Strong interpersonal and communication skills, with the ability to convey complex clinical information effectively.
- Familiarity with ICD-9-CM, ICD-10-CM/PCS, MS-DRG, APR-DRG, and other coding/clinical systems.
- Commitment to continuous learning in quality and utilization management through CME programs and self-study.
Benefits
- Competitive salary and compensation package.
- Flexible, remote work opportunities.
- Comprehensive healthcare, retirement, and wellness benefits.
- Professional development and continuing education support.
- Opportunity to make a significant impact on patient care quality and operational efficiency.
Jobgether is a Talent Matching Platform that partners with companies worldwide to efficiently connect top talent with the right opportunities through AI-driven job matching.
When you apply, your profile goes through our AI-powered screening process designed to identify top talent efficiently and fairly.
🔍 Our AI evaluates your CV and LinkedIn profile thoroughly, analyzing your skills, experience, and achievements.
📊 It compares your profile to the job’s core requirements and past success factors to determine your match score.
🎯 Based on this analysis, we automatically shortlist the three candidates with the highest match to the role.
🧠 When necessary, our human team may perform an additional manual review to ensure no strong profile is missed.
The process is transparent, skills-based, and free of bias — focusing solely on your fit for the role. Once the shortlist is completed, we share it directly with the company that owns the job opening. The final decision and next steps (such as interviews or additional assessments) are then made by their internal hiring team.
Colombia only
