What are the responsibilities and job description for the Internal Medicine - Physician position at CARIN Alliance?
Physician Advisor, Quality Utilization Management
This role involves providing clinical and management guidance to improve hospital processes, resource utilization, and patient care quality. Responsibilities include educating staff, leading UM committees, supporting care coordinators and clinical teams, and promoting proper resource utilization through physician engagement. The advisor attends rounds, monitors quality and cost metrics, and ensures compliance with regulatory standards. Key duties also involve managing documentation, handling appeals, analyzing payer trends, and developing strategies to reduce denials. Collaboration with hospital leadership, external payors, and clinical teams is essential for process improvement and operational efficiency. The position requires at least 5 years of clinical practice, strong leadership and communication skills, and a medical license. Preferred qualifications include participation in UM committees and prior physician advising experience.
This role involves providing clinical and management guidance to improve hospital processes, resource utilization, and patient care quality. Responsibilities include educating staff, leading UM committees, supporting care coordinators and clinical teams, and promoting proper resource utilization through physician engagement. The advisor attends rounds, monitors quality and cost metrics, and ensures compliance with regulatory standards. Key duties also involve managing documentation, handling appeals, analyzing payer trends, and developing strategies to reduce denials. Collaboration with hospital leadership, external payors, and clinical teams is essential for process improvement and operational efficiency. The position requires at least 5 years of clinical practice, strong leadership and communication skills, and a medical license. Preferred qualifications include participation in UM committees and prior physician advising experience.