Physician Advisor

Hartford HealthCare – Integrated Care Partners (ICP) is seeking a Per Diem Physician Advisor to join their team in Wethersfield, CT. In this role, you will serve as an integral member of the Clinical Resource Management team, partnering with nurses, attending physicians, and hospital leadership to ensure appropriate utilization of healthcare resources. You will provide physician leadership in utilization management, level-of-care determinations, regulatory compliance, and payer interactions. Practice Info Integrated Care Partners (ICP) is Hartford HealthCare's physician-led clinically integrated network. Role sits within the Clinical Resource Management team. 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 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 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