Physician Consultant

3 days ago


Philadelphia, Pennsylvania, United States Temple University Full time
Physician Advisor Job Description

At Temple University Hospital, we are seeking a highly skilled Physician Advisor to join our team. As a key member of our Clinical Analysis and appeals team, you will provide clinical expertise and guidance to ensure that our patients receive the highest quality care.

Key Responsibilities:
  • Act as the physician advisor for medical necessity appeals and for the Pennsylvania Medical assistance (PAMA) utilization reviews.
  • Provide clinical expertise and guidance to the Clinical Analysis and appeals team.
  • Act as a physician resource for the regulatory and revenue cycle denial and appeals processes for hospital activity, including utilization review for all PAMA cases, all UM denials and appeals.
Requirements:
  • Doctorate Degree: Medicine or Osteopathic Medicine (Required)
  • General Experience and strong working knowledge of the Interqual Criteria Set and hospital reimbursement systems (Required)
  • General Experience in a role dealing with Second and Third level appeals processes including direct experience with being an expert witness (Required)
  • General Experience in a managed care environment (Required)
  • General Experience in an Administrative Leadership role (Preferred)
  • MD-LIC - PA Medical Physician License (Required) or DO-LIC - PA Osteopathic Physician (Required)
About Temple University Hospital:

Temple University Hospital is a nationally respected teaching hospital on Temple University's bustling Health Sciences Center campus. The hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner, across the country and around the world. As the chief clinical training site for the Lewis Katz School of Medicine at Temple University, the hospital provides a dynamic environment for high-quality care, teaching, and cutting-edge research.

We are an Equal Opportunity Employer and welcome applications from diverse candidates. If you are passionate about delivering exceptional patient care and are committed to excellence, we encourage you to apply for this exciting opportunity.


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