Physician Advisor

Location: Remote - Nationwide within the United States

Salary: $198,000-$297,000 per year, based on relevant experience.

Company

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

What you will do

• Lead resource and utilization management to support quality, cost-effective care in the appropriate setting.
• Determine patient status for hospitalized patients and conduct short inpatient stay and daily observation reviews.
• Perform peer-to-peer reviews with payer medical directors and assist with denials and appeals.
• Partner with medical staff, hospital leadership, utilization review nurses, integrity and analytics staff, and case management to improve utilization management processes.
• Educate medical staff on utilization management topics and participate in utilization management committees as a subject matter expert.
• Track denial trends and provide reports to relevant medical and hospital leadership committees.

Requirements

• MD or DO physician qualification is required.
• Must reside in and be authorized to work within the United States.
• Experience with hospitalized patient status determinations, utilization management, peer-to-peer reviews, observation reviews, denials, and appeals.
• Ability to build relationships with medical staff and leadership and communicate decisions clearly.
• Ability to lead teams, coach others, delegate responsibilities, and manage programs or projects.

Culture & Benefits

• Healthcare, paid time off, retirement, and well-being benefits are available.
• Professional development includes a relevant professional certification and possible tuition reimbursement.
• Quarterly and annual incentive programs recognize strong performance.
• Work-life flexibility, collaboration, growth, innovation, and purpose-driven values are emphasized.
• The company offers reasonable accommodations in accordance with applicable disability-access laws.