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Physician Advisor

2 months ago

Dayton, Ohio, United States Premier Health Partners Full time

About the Role:

Premier Health Partners is seeking a highly skilled Physician Advisor to join our team. As a Physician Advisor, you will play a critical role in ensuring high-quality patient care across the care continuum.

Key Responsibilities:

  • Conduct thorough clinical reviews of cases referred by healthcare professionals to ensure compliance with regulatory requirements and optimal patient outcomes.
  • Collaborate with interdisciplinary teams, including ICM/CSI/care providers, to promote effective utilization of healthcare services and improve patient care.
  • Develop and deliver educational programs to physicians and clinicians on regulatory requirements, best practices, and evidence-based guidelines.
  • Participate in daily huddles and contribute to the utilization management team to drive quality improvement initiatives.
  • Stay up-to-date on federal, state, and payer regulatory requirements to ensure compliance and inform clinical decision-making.

Requirements:

  • Medical Doctorate degree (MD or DO) from an accredited institution.
  • Current physician licensure in Ohio.
  • CHCQM Physician Advisor certification.
  • Minimum 5 years of clinical practice experience, with a strong background in utilization management.

Preferred Qualifications:

  • Experience in clinical leadership or management.
  • Strong knowledge of payer practices and reimbursement models.
  • Excellent communication and interpersonal skills.