Physician Advisor (Healthcare)

Location: Remote nationwide within the United States; candidates must reside in and be authorized to work within the United States.

Company

hirify.global provides technology-enabled revenue cycle management solutions and point solutions for hospitals and affiliated physician groups across the United States.

What you will do

• Render compliant status determinations for hospitalized patients.
• Conduct peer-to-peer reviews with payers' medical directors.
• Review short inpatient stays and observation patients daily.
• Attend utilization management committees and support denials and appeals.
• Educate medical staff on utilization management topics and build relationships with clinical leadership.
• Partner with utilization review nurses, insurance authorization staff, and Case Management to strengthen utilization management processes and track denial trends.

Requirements

• Must reside in and be authorized to work within the United States.
• Experience with clinical status determinations and utilization management issues.
• Ability to conduct payer peer-to-peer reviews and support denials and appeals.
• Ability to collaborate with medical staff, utilization review nurses, insurance authorization staff, and Case Management.

Culture & Benefits

• Part-time employment with healthcare, time off, retirement, and well-being benefits.
• Professional certification relevant to the associate's field.
• Tuition reimbursement and professional development opportunities.
• Quarterly and annual incentive programs.
• Culture focused on collaboration, growth, innovation, work-life flexibility, and purpose.