Physician Advisor

Ensemble Health Partners

. Render compliant status determinations for hospitalized patients .

Posted 9/15/2026part-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in utilization management, including conducting peer-to-peer reviews and educating medical staff on relevant topics. Proven ability to collaborate with healthcare teams and track denial trends to enhance compliance and operational efficiency.

Highest-signal resume keywords

Utilization Management ExpertisePeer-To-Peer ReviewCollaboration With Medical StaffDenials And Appeals AssistanceTrend Tracking And Adaptation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ManagementPeer-To-Peer ReviewShort Inpatient Stay ReviewObservation Patient ReviewDenial ManagementAppeals ProcessTrend Analysis

Soft Skills

Relationship BuildingEducation And TrainingCollaboration

Industry Keywords

Utilization Management IssuesMedical DirectorsCase ManagementInsurance Authorization

About the role

Key responsibilities & impact

Render compliant status determinations for hospitalized patients
Conduct peer-to-peer reviews with payors' medical directors
Serve as a subject matter expert on utilization management issues
Review short inpatient stays and observation patients daily
Build relationships with medical staff and leadership to support utilization management initiatives
Attend utilization management committees
Assist with denials and appeals
Educate medical staff on utilization management topics
Partner with utilization review nurses, insurance authorization staff, and Case Management to strengthen utilization management processes
Track denial trends and help the team adapt to evolving payor challenges

Requirements

What you’ll need

Physician role involving utilization management and physician advisory responsibilities
Must reside and be authorized to work within the United States
Applications from outside the United States will not be considered
Knowledge of utilization management issues
Ability to conduct peer-to-peer reviews with payors' medical directors
Ability to review short inpatient stays and observation patients
Ability to collaborate with utilization review nurses, insurance authorization staff, and Case Management
Ability to attend utilization management committees
Ability to assist with denials and appeals
Ability to educate medical staff on utilization management topics
Ability to track denial trends and adapt to evolving payor challenges

Benefits

Comp & perks

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 for employees who go beyond expectations
Work-life flexibility
Professional development opportunities