Physician Advisor

Key Responsibilities:

• Clinical Review & Guidance: Provide expert medical opinions on case reviews, medical necessity determinations, and appeals.
• Regulatory Compliance: Ensure adherence to Medicare, Medicaid, and other payer guidelines.
• Utilization Management: Assist in reviewing claims for appropriate utilization of healthcare services.
• Quality Improvement Initiatives: Work with healthcare providers to enhance patient outcomes and reduce errors.
• Education & Training: Train healthcare providers on evidence-based practices, proper documentation, and regulatory compliance.

Job Requirements

-Education & Licensing

Medical Degree (MD, DO, PsyD) from an accredited institution.

Board Certification in a relevant specialty (e.g., Internal Medicine, Family Medicine, Psychiatry.).

Active, Unrestricted Medical License in New York State.

Experience

• At least 5 years of clinical practice experience.
• At least 10 years of overall medical experience.
• Experience in utilization review, case management, or quality improvement.
• Familiarity with CMS guidelines, Medicare/Medicaid policies, and national quality measures.

Skills & Competencies

• Strong understanding of evidence-based medicine and medical necessity criteria.
• Knowledge of HIPAA, CMS, and healthcare compliance standards.
• Ability to analyze clinical cases objectively and communicate findings effectively.
• Proficiency with electronic health records (EHRs) and data analytics tools.

Indotronix is an Equal Opportunity Employer