Physician Advisor - Des Moines (on-site) - $50,000 Bonus
On-site · Des Moines, Iowa, United States
Job Summary
Lead physician-driven clinical resource utilization program and collaborate with MercyOne Leadership to design interventions. Review cases to determine appropriate level of care based on medical necessity and apply regulatory, health plan, and clinical guidelines in the review of denials. Serve as a resource for physicians regarding medical necessity, level of care, and clinical documentation; foster effective communication within the care team; establish and maintain peer-to-peer protocol. On-site role based in Des Moines, IA, with MercyOne Central Iowa.
Required Qualifications
- Board-certified physician
- Inpatient experience
- Strong knowledge of CMS and commercial insurance regulations
- Team-building mindset
- Collaborative approach to decision making
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