Physician Advisor

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

⏰ Full Time

🟢 Junior

👻 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.

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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

• Conduct physician-to-physician reviews for medical necessity, level of care, and denial prevention/appeals • Support utilization review and case management teams with complex clinical decision-making • Communicate with the Physician Advisory team, hospital physicians, care coordination, and utilization management staff to promote evidence-based care and documentation • Assist in improving documentation related to ICD coding, severity of illness, risk of mortality, and DRG assignment • Keep current with CMS and MCG evidence-based guidelines • Maintain compliance with legal, regulatory, accreditation, and payer partner requirements • Meet productivity and quality standards within established time requirements • Attend required training and meetings • Participate in peer review as needed • Protect and disclose patients’ PHI in accordance with HIPAA standards • Limit PHI access to the minimum necessary for assigned duties • Perform other duties as assigned

🎯 Requirements

• MD or DO with an active, unrestricted medical license • US Board Certified in a recognized specialty • Minimum of 1 year of payer or provider-side utilization review, or active ACPA and/or ABQUARP certification • Basic technical skills with hospital EMRs • Strong knowledge of utilization management, medical necessity, and payer regulations • Familiarity with MCG/InterQual placement status criteria preferred • Membership in the American College of Physician Advisors (ACPA) preferred • Ability to effectively present information, both formally and informally • Proficiency in Microsoft Office Suite • Strong interpersonal and communication skills • Strong problem-solving and creative skills, with sound judgment and ability to make decisions based on accurate and timely analyses • High integrity and dependability, with a strong sense of urgency and results orientation • Excellent written and verbal communication skills • Ability to use a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes • Ability to follow directions, collaborate with others, and handle stress

🏖️ Benefits

• Multifactor authentication and security support via a required smartphone or electronic device • Compliance with HIPAA, information security, legal, regulatory, accreditation, and payer partner policies • Equal employment opportunity protections