449 Pharmaceutical Advisor jobs in the United States
Medical Advisor, Physician
Philadelphia, Mississippi
Temple Health – Temple University Health System
Posted today
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Job Description
Provides clinical expertise and guidance to Clinical Analysis and appeals team. Acts as the physician advisor for medical necessity appeals and for the Pennsylvania Medical assistance (PAMA) utilization reviews. Acts as a physician resource for the regulatory and revenue cycle denial and appeals processes for hospital activity, including utilization review for all PAMA cases, all UM denials and appeals.
Education
Doctorate Degree Medicine or Osteopathic Medicine Required
Experience
General Experience and strong working knowledge of the Interqual Criteria Set and
hospital reimbursement systems Required
General Experience in a role dealing with Second and Third level appeals processes
including direct experience with being an expert witness Required
General Experience in a managed care environment Required
General Experience in an Administrative Leadership role Preferred
Licenses
PA Medical Physician License Required or
PA Osteopathic Physician Required
Our Hospital/Organization Descriptions
Your Tomorrow is Here!
Temple University Hospital is a nationally respected teaching hospital on Temple University's bustling Health Sciences Center campus. The hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner, across the country and around the world. As the chief clinical training site for the Lewis Katz School of Medicine at Temple University, the hospital provides a dynamic environment for high-quality care, teaching, and cutting edge research.
Education
Doctorate Degree Medicine or Osteopathic Medicine Required
Experience
General Experience and strong working knowledge of the Interqual Criteria Set and
hospital reimbursement systems Required
General Experience in a role dealing with Second and Third level appeals processes
including direct experience with being an expert witness Required
General Experience in a managed care environment Required
General Experience in an Administrative Leadership role Preferred
Licenses
PA Medical Physician License Required or
PA Osteopathic Physician Required
Our Hospital/Organization Descriptions
Your Tomorrow is Here!
Temple University Hospital is a nationally respected teaching hospital on Temple University's bustling Health Sciences Center campus. The hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner, across the country and around the world. As the chief clinical training site for the Lewis Katz School of Medicine at Temple University, the hospital provides a dynamic environment for high-quality care, teaching, and cutting edge research.
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