Physician Advisor

Physician AdvisorUnder the general direction of the Medical Director, Director, or designee, the Physician Advisor is responsible for reviewing applicant medical records and making a clinical determination of eligibility for applicants seeking benefits and/or long term care services based on clinical guidelines. The Physician Advisor also provides clinical guidance reviewers and quality improvement initiatives as appropriate.Major ResponsibilitiesResponsible for determining whether an individual applying for and/or receiving public assistance benefits/services meets specific clinical and functional criteria outlined in federal and state regulationsReview medical records, approves or denies recommendations made by Registered Nurse Reviewers regarding the status of an applicant or memberParticipates in and advises review team regarding the functional capability of an applicant based upon a comprehensive review of all recordsContributes to quality improvement initiatives developed within the program or departmentParticipates in quality team case reviewsCollaborate with department leadership in the interpretation of all applicable regulations, development of clinical policies and quality evaluations, and provide feedback to clinical staff regarding clinical policies and the outcomes of quality evaluationsEvaluates and develops alternatives to address problems and issues as they arise on a case by case basisParticipates as a member of clinical or case review teamsResponsible for training new Physician AdvisorsPerforms other duties as assigned.Required QualificationsBoard eligible or certified in area of specialtyMinimum of 5 years of experience in direct patient careProven ability to plan and prioritize work in order to meet position objectives or job responsibilitiesExcellent problem solving and decision making capabilities