Physician Advisor Per Diem - Clinical Resource Management

Per Diem Physician Advisor

Hartford HealthCare includes eight acute care hospitals, a large multispecialty physician organization, behavioral health services, rehabilitation, home care, senior services, and an extensive network of ambulatory locations throughout the state. Our physician-led organization is committed to collaboration, clinical excellence, and creating an environment where providers can thrive.

Position Summary

The Physician Advisor serves as an integral member of the Clinical Resource Management team, partnering closely with Clinical Resource Management nurses, attending physicians, and hospital leadership to ensure the appropriate utilization of healthcare resources while maintaining the highest standards of patient care. This role provides physician leadership in utilization management, level-of-care determinations, regulatory compliance, and payer interactions, helping to ensure that patients receive the right care, at the right time, in the most appropriate setting.

Key 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.

Why Hartford HealthCare?

As a physician with Hartford HealthCare, you will join a nationally recognized, physician-led organization committed to clinical excellence, innovation, and collaboration. You will work alongside exceptional colleagues while helping shape the delivery of high-quality, patient-centered care across Connecticut's largest integrated healthcare network.

Qualifications

Education: Doctor of Medicine or Doctor of Osteopathic Medicine

Experience: Three to five years of acute experience. Five years of relevant experience, acute care or managed care is preferred.

Licensure, Certification, Registration: Valid State of CT Physician License

Knowledge, Skills and Ability Requirements:

• 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