The Physician Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key responsibilities include conducting clinical reviews, consulting with Physicians on patient status and resource use, collaborating with care management and health information management (HIM) to improve documentation and coding, and acting as a liaison with third-party payers for appeals and authorizations. The goal is to ensure accurate reimbursement, efficient use of hospital services, adherence to regulations, and ultimately, better patient care and outcomes.

Education & Experience Requirements: