Physician Advisor

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $198k - $297k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

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Ensemble Health Partners

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Private Equity Round on 2022-03

Consulting • Insurance • Logistics

Ensemble Health Partners is a leading provider of revenue cycle management (RCM) services for healthcare organizations. They offer an end-to-end RCM solution that helps hospitals, health systems, and affiliated physician groups optimize their revenue cycles, reduce denials and underpayments, and enhance patient experiences using a combination of expert management and advanced technology. Ensemble Health Partners leverages certified operators and AI to deliver consistent results, improve collections, and support future growth for healthcare providers. They are recognized for their robust client partnerships and commitment to delivering reliable revenue lift and cost savings for their clients.

📋 Description

• Render compliant status determinations for hospitalized patients • Conduct peer-to-peer reviews with payors’ medical directors • Review short inpatient stays and observation patients daily • Build relationships with medical staff and leadership to gain support for utilization management initiatives • Attend utilization management committees as a subject matter expert • Assist with denials and appeals • Educate medical staff on utilization management topics • Partner with utilization review nurses, insurance authorization staff, and Case Management to maintain and improve utilization management processes • Track denial trends to help the team adapt to evolving payor challenges • Make day-to-day leadership decisions and communicate decisions to appropriate teams • Coach, develop, delegate to, and lead teams • Manage programs and projects from inception through completion or implementation, including budget and resource planning

🎯 Requirements

• MD/DO Physician (MUST have) • Must reside and be authorized to work within the United States • Physician expertise in utilization management • Ability to render compliant status determinations for hospitalized patients • Ability to perform peer-to-peer reviews with payors’ medical directors • Ability to review short inpatient stays and observation patients • Ability to assist with denials and appeals • Ability to educate medical staff on utilization management topics

🏖️ Benefits

• Comprehensive benefits package including healthcare, time off, retirement, and well-being programs • Professional certification relevant to the associate’s field • Tuition reimbursement • Quarterly and annual incentive programs • Work-life flexibility • Professional development opportunities • Remote work environment