Physician Advisor II

🔥 16 minutes ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Med-Metrix

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2010

🏥 Healthcare

☁️ SaaS

💰 Private equity on 2025-09

Healthcare • SaaS

Med-Metrix is a company for which only a minimal web presence was provided (the page only displayed "Loading application... Your web browser must have JavaScript enabled... "). No product, market, or mission details were included in the supplied text. Based on the company name alone, it plausibly focuses on medical or clinical metrics, analytics, or healthcare software, but that is speculative and not confirmed by the provided information. Further public details would be required to be more specific.

📋 Description

• Lead the Physician Advisor team and mentor and teach internal and external stakeholders • Maintain quality across the Physician Advisor team and manage PAOC client relationships • Perform case reviews of all case types to achieve a high degree of compliance • Respond to clinical review requests regarding medical necessity and other case management matters • Consult with attending physicians, nurses, and case management staff on complex clinical issues, continued stay, medical necessity, and utilization management • Apply MCG/InterQual criteria and professional judgment to patient-specific situations • Support case management outcomes and clinical progression of patient care • Recommend improvements to health record documentation affecting ICD code capture, severity, acuity, mortality risk, and DRG assignment • Participate in Physician Advisor, Utilization Management, Care Management, and related training and education • Meet production, quality, and performance standards • Maintain patient and business confidentiality and comply with HIPAA and information security policies • Facilitate, mentor, and educate physicians regarding payer requirements • Attend meetings and participate in peer review as requested • Manage PAOC client relationships, quarterly reports, and JOCs • Contribute to PAOC’s quality program and continuous Physician Advisor development • Educate client-facility staff on relevant topics • Mentor and train new and existing Physician Advisors • Serve as Team Lead for Physician Advisor dashboard management when scheduled • Perform additional duties as assigned

🎯 Requirements

• Specialty Board Certified • Licensed to practice medicine in the US • 3+ years working as a Physician Advisor or UR/UM Medical Director performing case reviews • Basic technical skills with Hospital EMRs and Microsoft Office and Teams • Hold and maintain an unrestricted medical license and Board Certification • Possess or acquire a solid foundation, knowledge, and/or experience in utilization management, quality improvement, and patient safety • Possess a working knowledge of hospital organization, case management operations, and administrative standards and policies • Proficiency in Microsoft Office Suite • Strong interpersonal skills and ability to communicate well at all levels of the organization • Strong problem-solving and creative skills, with the ability to exercise sound judgment and make decisions based on accurate and timely analyses • High level of integrity and dependability with a strong sense of urgency and results orientation • Excellent written and verbal communication skills • Familiarity with MCG/InterQual placement status criteria is preferred • Membership in the American College of Physician Advisors (ACPA) is preferred • Board Certification by ABQAURP is preferred • Physician Advisor Sub-Specialty Certification by ABQAURP is preferred • Must possess a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes

🏖️ Benefits

• Holiday coverage requirement of up to 3 holidays per year • Multifactor authentication and security device support requirement (smart-phone or electronic device capable of downloading applications)