Physician Advisor

Hartford Health Care - Integrated Care Partners (ICP) invites you to join their team as a Per Diem Physician Advisor. In this role, you will serve as an integral member of the Clinical Resource Management team, partnering with nurses and attending physicians to ensure the appropriate utilization of healthcare resources. You will provide physician leadership in utilization management, level-of-care determinations, regulatory compliance, and payer interactions to deliver high-value care.

Practice Info

• 1290 Silas Deane Hwy Wethrsfld (10181)
• Integrated Care Partners (ICP) is Hartford Health Care's physician-led clinically integrated network
• Clinical Resource Management team setting

Responsibilities

• Perform second-level physician reviews for level-of-care determinations and appropriate utilization of healthcare resources.
• Respond promptly to requests from Clinical Resource Management nurses for physician review.
• Collaborate with attending physicians to resolve level-of-care questions and address opportunities for appropriate resource utilization.
• Conduct peer-to-peer discussions with insurance payers and provide support for appeals and denial management.
• Maintain current knowledge of regulatory requirements, utilization management standards, and payer guidelines.
• Educate physician colleagues on utilization management best practices and evolving regulatory trends.
• Meet established Physician Advisor coverage requirements for assigned per diem shifts.
• Participate in quality improvement initiatives and perform other duties as assigned.

Shift & Schedule

• Per Diem
• Days/time vary. Include wkends/holidays

Qualifications

• Doctor of Medicine or Doctor of Osteopathic Medicine
• Three to five years of acute experience
• Five years of relevant experience, acute care or managed care is preferred
• Valid State of CT Physician License
• Able to influence, negotiate and educate
• Ability to understand and interpret patient data, finance and utilization reports
• Understanding of government and payer coverage criteria and regulatory requirements