Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

AI-Driven Physician Advisor: Utilization & Appeals

Full-time

Xsolis, Inc

XSOLIS is seeking a Physician Advisor to provide concurrent review and appeal support for its XPAS client base. You will apply utilization management expertise, review cases for level of care, and help ensure compliance with CMS and state regulations.

This full-time role involves collaborating with care management and providers, documenting decisions, and contributing to the evolution of XSOLIS's clinical analytics platform. Travel to TN for training is required.

#J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the AI-Driven Physician Advisor: Utilization & Appeals in United States vacancy
  •  ...Overview This role evaluates and shapes AI tools that support clinical review,...  ...level-of-care decisions. Manage the physician advisor program to support complex UM cases, peer-to-peer review requests, and denial appeals. Coordinate with clinical teams, payers... 
    Suggested
    Hourly pay
    Remote work
    Night shift

    SaidGig

    United States
    5 days ago
  • A leading healthcare organization is seeking a RCS-Physician Advisor to join their Denial Management team. This full-time remote position...  ...excellent communication skills and strong leadership abilities to help optimize hospital services and resource utilization. #J-18808-Ljbffr
    Suggested
    Full time
    Remote work

    Indiana University Health

    Indiana, PA
    1 day ago
  •  ...measurable enterprise value through data-driven finance transformation.You Are:A finance-...  ....Minimum of 1 year of experience serving utilities clients (electric, gas, or water) or in a...  ...Cloud, Smart View) and use of GenAI/agentic AI in finance.You have experience working in... 
    Suggested
    Full time
    Work experience placement
    Live in
    Work at office
    Local area

    Accenture

    Atlanta, GA
    20 hours ago
  • Henry Ford Health seeks a Physician Advisor to collaborate with medical staff leadership to optimize resource use and ensure quality care. The role requires extensive experience in utilization management, regulatory knowledge, and strong physician engagement across hospital... 
    Suggested

    Henry Ford Health

    Detroit, MI
    10 hours ago
  • Henry Ford Health System in Detroit seeks a Physician Advisor responsible for overseeing healthcare service utilization and compliance. The role includes collaboration with medical staff to promote quality care while managing resources effectively. Applicants should possess... 
    Suggested
    Full time

    Henry Ford Health System

    Detroit, MI
    2 days ago
  • Washington Hospital Healthcare System seeks a Lead Physician Advisor to optimize patient care and ensure regulatory compliance across inpatient...  ...requires MD degree, CA license, and extensive experience in utilization management, CDI, and case management. Strong analytical and... 

    Washington Hospital Healthcare System

    Fremont, CA
    2 days ago
  • Henry Ford Health is seeking a Physician Advisor to partner with medical leadership, hospital staff, and revenue cycle teams to optimize utilization and ensure high-quality patient care across the system. You will lead medical necessity reviews, mentor clinicians on documentation... 

    NEJM

    Detroit, MI
    2 days ago
  • Med-Metrix is seeking a Physician Advisor to perform case reviews across all types to ensure compliance and optimize hospital resource use...  ...medical license with 3+ years in physician advisory roles, and is proficient with EMR systems and utilization #J-18808-Ljbffr Med-Metrix

    Med-Metrix

    Parsippany, NJ
    2 days ago
  • $100 per hour

    A leading AI research firm is seeking a Remote Investment Banking Specialist to utilize strong M&A and IPO experience in shaping AI-driven capital markets analysis. This flexible consulting role offers $100/hr compensation, allowing for part-time engagement from any location... 
    Remote job
    Part time
    Flexible hours

    Turing

    Los Angeles, CA
    20 hours ago
  • $159.68k - $232.27k

    A defense solutions provider is hiring an Advisor, Senior for their U.S. Navy program in Arlington, Virginia. This role involves developing...  ...strategic direction, advising on program effectiveness, and utilizing advanced analytics for readiness assessments. The ideal... 

    Sabre Systems Inc.

    Arlington, VA
    4 days ago
  • General Summary:The System Physician Advisor for CDI serves as a key liaison between Quality,...  ...Report.Reporting Structure:• Direct: Chief Utilization Officer• Dotted Line: Chief Quality...  ...Participate in audits and assist with appeals related to clinical documentation and... 

    Henry Ford Health

    Detroit, MI
    4 days ago
  •  ...Health is seeking a highly motivated Physician Advisor to partner with physicians, Care Management...  ...leadership to ensure appropriate utilization of healthcare resources, regulatory compliance...  ..., denials prevention and appeals, physician education, and length-of-stay... 
    Daily paid
    Full time
    Part time
    Worldwide

    St. Joseph's Health

    Paterson, NJ
    4 days ago
  • $242.11k - $387.38k

     ...System Office-ValleyPosition Overview:The Physician Advisor (PA) is a key member of the hospital's...  ...for ensuring the effective, efficient utilization of health care services. The PA will...  ...Operations: Clinical Denials and Appeals, Recovery Audit Contractor (RAC), Medicare... 
    Full time
    For contractors
    Work at office
    Shift work
    Night shift

    Sutter Health

    Modesto, CA
    20 hours ago
  • A prominent healthcare group in New York is seeking a Physician Advisor to lead the Utilization Management team at their South Brooklyn campus. The role involves providing direct patient care and ensuring compliance with regulations. Ideal candidates will be board certified... 

    Physician Affiliate Group of New York

    New York, NY
    2 days ago
  • RWJBarnabas Health is seeking a full-time Physician Advisor in New Jersey to collaborate with administration, medical staff, and case management. The role focuses on utilization management, progression of care, and complex discharge planning across multiple departments... 
    Full time

    340B Health

    New Brunswick, NJ
    2 days ago
  • Fiserv in New Jersey/New York seeks a Product Analyst, Advisor I to support the transaction enrichment product across Cards offerings,...  ...enhancements that scale enrichment capabilities. The role focuses on data-driven analysis, defining requirements, and supporting roadmap... 

    Shoptalk

    Berkeley Heights, NJ
    4 days ago
  •  ...TH Associate Administrator / Clinical Utilization Advisor. The Clinical Utilization Advisor plays...  ...that will work closely with the Physician Advisor, and reports to the Chief Medical...  ...Denial Prevention, Management & Appeals Support: Support the denial management... 
    Full time

    SUNY Downstate Medical Center

    New York, NY
    4 days ago
  •  ...and Responsibilities Overview The Physician Advisor is a full-time administrative physician...  ...patterns, documentation, over- and under-utilization of resources, medical necessity,...  ...(but not limited to): ?Denial trends, appeals & recoveries ?Length of stay- inpatient... 
    Full time
    Relocation package

    CHRISTUS Health

    Texarkana, TX
    a month ago
  •  ...Description: *Please note: Experienced Physician Advisor's only and no part time inquiries*...  ...communicating with hospital physicians, utilization management, case management, CDI, the...  ...Functions Review denials and author appeal letters as needed Perform peer to peers... 
    Part time
    Work experience placement
    Work at office

    Brundage Medical Group LLC

    Pinellas Park, FL
    more than 2 months ago
  • At Houston Methodist, the Physician Advisor position is responsible for teaching, consulting,...  ...patterns; documentation and over- and under-utilization of resources. This position is a key...  ...to what extent denied cases will be appealed. Review cases that indicate need for... 
    Full time

    Houston Methodist

    Houston, TX
    7 days ago
  •  ...Manufacturing Sector is seeking an accomplished Utilities Industry Solutions Subject Matter Expert...  ...view on trends such as grid resiliency, AI‑driven asset intelligence, outage prediction,...  ...conversationsAct as a trusted industry advisor and deal shaper, influencing scope,... 
    Remote work

    NTT DATA

    Dallas, TX
    20 hours ago
  •  ...PRN Physician Advisor Opportunity Ascension in Austin, TX is looking for a PRN (Per-Request...  ...preferably with some physician advisory or utilization management work experience. If you are...  ...with peer-to-peer discussions and appeal reviews. Provide education to... 
    Work experience placement
    Relief
    Local area
    Remote work

    Ascension

    United States
    1 day ago
  • $100 per hour

     ...00    Position Summary   The Lead Physician Advisor serves as a Washington Health leader by...  ...in interdisciplinary teams, including utilization review committees and quality...  ...well as handle second-level reviews and appeals for cases requiring additional clinical... 
    Full time
    Work experience placement
    Work at office
    Local area

    Washington Hospital

    Fremont, CA
    19 days ago
  • $285k - $325k

     ...opening for a full‑time Internal Medicine physician at our Long Beach Los Altos primary care...  ...patient scheduled at 4:30 pm) EMR: Epic AI assisted technology for clinical...  ...valuable benefits. Our compensation model utilizes fair market value data specific to your specialty... 
    Full time
    Freelance
    Immediate start

    Jobleads-US

    Long Beach, CA
    20 hours ago
  •  ...Job Title Physician Advisor Company Allegheny Health Network Job Description The...  ...with both government and commercial payer utilized regulations and criteria regarding...  ...status and case management. Assists with appeal letters and participates in data collection... 
    Full time
    For contractors
    Local area
    Immediate start
    Relocation package

    Highmark Health

    Erie, PA
    8 hours ago
  •  ...Physician Advisor Location: St. Mary Medical Center - Hobart, IN 46342 The Physician Advisor...  ...provide clinical expertise to support utilization management (UM) and quality...  ...a liaison with third-party payers for appeals and authorizations. The goal is to ensure... 

    219 Health Network

    Hobart, IN
    1 day ago
  •  ...On-Site Physician Advisor Virginia Beach, VA First (Days) The On-Site Physician Advisor...  ...in support of the centralized system Utilization Review process for Sentara hospital facilities...  ...as appropriate, and assisting with appeals letters. Work closely with hospital... 
    Full time

    Sentara Healthcare

    Virginia Beach, VA
    4 days ago
  •  ...Job Title Physician Advisor Company Allegheny Health Network Location Pittsburgh...  ...with both government and commercial payer utilized regulations and criteria regarding...  ...status and case management. Assists with appeal letters and participates in data... 
    Full time
    For contractors
    Local area

    Highmark Health

    Pittsburgh, PA
    9 hours ago
  •  ...PT Physician Advisor The Physician Advisor serves as a liaison for Hospital Administration...  ...facilitating compliance with the hospital's Utilization Plan and established Case Management...  ...and signing medical necessity appeal letters based on appropriateness of level... 

    JPS Health Network

    Fort Worth, TX
    9 hours ago
  •  ...Physician Advisor Location: Suffolk, VA Work Shift: First (Days) Overview: The Physician...  ...in support of the centralized system Utilization Review (UR) process for Sentara...  ...payers as appropriate, and assisting with appeals letters Work closely with hospital... 
    Temporary work
    Shift work

    Sentara Healthcare

    Suffolk, VA
    4 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to AI-Driven Physician Advisor: Utilization & Appeals. Be the first to apply!