Physician Advisor
Full Job Posting
Qualifications
- MINIMUM JOB SPECIFICATIONS:
- MD or DO from an accredited medical school; current, unrestricted New Jersey medical license and eligibility for AtlantiCare medical staff membership
- Board certification in a clinical specialty; certification in health care quality, utilization management, or physician advising preferred
- Minimum five years of recent clinical practice experience; acute-care experience preferred
- Working knowledge of utilization management, CDI, coding and reimbursement, medical necessity, level-of-care criteria, denials and appeals, and applicable federal, state, and payer requirements
- Experience with evidence-based criteria such as MCG and proficiency with electronic health records and related clinical systems
- Strong clinical judgment, analytical ability, communication, physician engagement, education, collaboration, organization, and change-management skills
Preferred Qualifications
- Board certification in a clinical specialty; certification in health care quality, utilization management, or physician advising preferred
- Minimum five years of recent clinical practice experience; acute-care experience preferred
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