As a key member of the hospital's Utilization Review Committee (URC), the Physician Advisor ... This position may be filled on a full-time or part-time basis, with a minimum commitment of 0.5 FTE
As a key member of the hospital's Utilization Review Committee (URC), the Physician Advisor ... This position may be filled on a full-time or part-time basis, with a minimum commitment of 0.5 FTE
Peer Review Nurse
Madera, CA · On-site
$46 - $61.91/hr
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
Peer Review Nurse
Madera, CA · On-site
$46 - $61.91/hr
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
Peer Review Nurse
Madera, CA · On-site
$46 - $61.91/hr
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
Peer Review Nurse
Madera, CA · On-site
$46 - $61.91/hr
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
Peer Review Nurse
Madera, CA · On-site
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
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Peer Review Nurse
Madera, CA · On-site
Will facilitate the peer review process and attend peer review meetings. Part Time Position with ... and utilization review. Requires proficiency in data abstraction, EHR systems, and critical ...
Professional Review Nurse
Folsom, CA · Remote
$70K - $85K/yr
P.T. and I.C.D.9 codes preferred * Medical bill auditing experience preferred * Experience in the ... Prospective, concurrent and retrospective utilization review experience preferred PAY RANGE: CorVel ...
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Professional Review Nurse
Folsom, CA · Remote
$70K - $85K/yr
P.T. and I.C.D.9 codes preferred * Medical bill auditing experience preferred * Experience in the ... Prospective, concurrent and retrospective utilization review experience preferred PAY RANGE: CorVel ...
... utilization review accreditation commission (URAC) certifications. Provides leadership and ... Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics (P&T) and ...
... utilization review accreditation commission (URAC) certifications. Provides leadership and ... Attends or chairs committees as required such as credentialing, Pharmacy and Therapeutics (P&T) and ...
AOD Counselor * Part Time*
Shingle Springs, CA · On-site
$24 - $30/hr
... and part time employees · Free Legal consultations and benefits for full time and part time ... Cooperate with health insurance clinical utilization reviews. Provide daily Progress Notes and ...
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AOD Counselor * Part Time*
Shingle Springs, CA · On-site
$24 - $30/hr
... and part time employees · Free Legal consultations and benefits for full time and part time ... Cooperate with health insurance clinical utilization reviews. Provide daily Progress Notes and ...
AOD Counselor * Part Time*
Shingle Springs, CA · On-site
$23 - $31/hr
... and part time employees • Free Legal consultations and benefits for full time and part time ... Cooperate with health insurance clinical utilization reviews. Provide daily Progress Notes and ...
AOD Counselor * Part Time*
Shingle Springs, CA · On-site
$23 - $31/hr
... and part time employees • Free Legal consultations and benefits for full time and part time ... Cooperate with health insurance clinical utilization reviews. Provide daily Progress Notes and ...
Clinical Director II - Part-Time Hybrid
Sacramento, CA · Hybrid
$41 - $43.51/hr
Turning Point Community Programs is seeking a part-time Clinical Director II for our Sac Kaiser TBS ... Represents the agency at County utilization review; participates in off-site trainings and provides ...
Clinical Director II - Part-Time Hybrid
Sacramento, CA · Hybrid
$41 - $43.51/hr
Turning Point Community Programs is seeking a part-time Clinical Director II for our Sac Kaiser TBS ... Represents the agency at County utilization review; participates in off-site trainings and provides ...
Experience and current knowledge of Quality Assurance, Utilization Review, Peer Review and programs * At least three (3) years of direct patient care medical practice experience * At least three (3) ...
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Experience and current knowledge of Quality Assurance, Utilization Review, Peer Review and programs * At least three (3) years of direct patient care medical practice experience * At least three (3) ...
Case Manager II - PT Days
San Leandro, CA · On-site
$64.55 - $81.87/hr
Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise ...
Case Manager II - PT Days
San Leandro, CA · On-site
$64.55 - $81.87/hr
Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise ...
Psychiatric Nurse Practitioner (Part-Time) POSITION SUMMARY The Psychiatric Nurse Practitioner ... Current DEA registration and CURES (Controlled Substance Utilization Review and Evaluation System ...
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Psychiatric Nurse Practitioner (Part-Time) POSITION SUMMARY The Psychiatric Nurse Practitioner ... Current DEA registration and CURES (Controlled Substance Utilization Review and Evaluation System ...
Clinical Director II - Part-Time Hybrid
Sacramento, CA · On-site
$41 - $43.51/hr
Represents the agency at County utilization review; participates in off-site trainings and provides ... Full-Time/Part-Time Part-Time Shift Various Shifts Exempt/Non-Exempt Exempt Open Date 10/31/2023 ...
Clinical Director II - Part-Time Hybrid
Sacramento, CA · On-site
$41 - $43.51/hr
Represents the agency at County utilization review; participates in off-site trainings and provides ... Full-Time/Part-Time Part-Time Shift Various Shifts Exempt/Non-Exempt Exempt Open Date 10/31/2023 ...
Psychiatric Nurse Practitioner
Antioch, CA · On-site
$138K - $177K/yr
Psychiatric Nurse Practitioner (Part-Time) POSITION SUMMARY The Psychiatric Nurse Practitioner ... Current DEA registration and CURES (Controlled Substance Utilization Review and Evaluation System ...
Psychiatric Nurse Practitioner
Antioch, CA · On-site
$138K - $177K/yr
Psychiatric Nurse Practitioner (Part-Time) POSITION SUMMARY The Psychiatric Nurse Practitioner ... Current DEA registration and CURES (Controlled Substance Utilization Review and Evaluation System ...
Psychiatric Nurse Practitioner
Antioch, CA · On-site
$176K - $215K/yr
Psychiatric Nurse Practitioner (Part-Time) POSITION SUMMARY The Psychiatric Nurse Practitioner ... Current DEA registration and CURES (Controlled Substance Utilization Review and Evaluation System ...
Psychiatric Nurse Practitioner
Antioch, CA · On-site
$176K - $215K/yr
Psychiatric Nurse Practitioner (Part-Time) POSITION SUMMARY The Psychiatric Nurse Practitioner ... Current DEA registration and CURES (Controlled Substance Utilization Review and Evaluation System ...
Speech Language Pathologist Part-Time
Bakersfield, CA · On-site
$55 - $70/hr
Speech-Language Pathologist (SLP) - Part-Time Kern River Transitional Care - Bakersfield, CA Pay ... Participate in Patient Care Conferences, Utilization Review meetings, and Rehabilitation ...
Speech Language Pathologist Part-Time
Bakersfield, CA · On-site
$55 - $70/hr
Speech-Language Pathologist (SLP) - Part-Time Kern River Transitional Care - Bakersfield, CA Pay ... Participate in Patient Care Conferences, Utilization Review meetings, and Rehabilitation ...
Optometrist
Vista, CA · On-site
$68 - $70/hr
Participate in quality assurance, quality improvement and utilization review * Examine the eyes of ... PART_TIME
Optometrist
Vista, CA · On-site
$68 - $70/hr
Participate in quality assurance, quality improvement and utilization review * Examine the eyes of ... PART_TIME
Family Practice Physician (MD/ DO)
$230K - $240K/yr
Support quality improvement initiatives, utilization review activities, and ongoing patient care ... Flexible Full-Time or Part-Time opportunities available. Monday through Friday schedule. No call ...
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Family Practice Physician (MD/ DO)
$230K - $240K/yr
Support quality improvement initiatives, utilization review activities, and ongoing patient care ... Flexible Full-Time or Part-Time opportunities available. Monday through Friday schedule. No call ...
Access Service Representative II - Transplant - 8010 Frost Street - Days - Part Time (0.6)
San Diego, CA · On-site
$25.55 - $31.86/hr
Performs all patient admission functions and basic utilization review/insurance verification activities to facilitate maximum financial reimbursement. Required Qualifications * H.S. Diploma or ...
Access Service Representative II - Transplant - 8010 Frost Street - Days - Part Time (0.6)
San Diego, CA · On-site
$25.55 - $31.86/hr
Performs all patient admission functions and basic utilization review/insurance verification activities to facilitate maximum financial reimbursement. Required Qualifications * H.S. Diploma or ...
Access Service Representative II - Transplant - 8010 Frost Street - Days - Part Time (0.6)
San Diego, CA · On-site
$25.55 - $31.86/hr
Performs all patient admission functions and basic utilization review/insurance verification activities to facilitate maximum financial reimbursement. Required Qualifications * H.S. Diploma or ...
Access Service Representative II - Transplant - 8010 Frost Street - Days - Part Time (0.6)
San Diego, CA · On-site
$25.55 - $31.86/hr
Performs all patient admission functions and basic utilization review/insurance verification activities to facilitate maximum financial reimbursement. Required Qualifications * H.S. Diploma or ...
Part Time Utilization Review information
See California salary details
$21.11 - $25.38
2% of jobs
$25.38 - $29.65
9% of jobs
$32.58 is the 25th percentile. Wages below this are outliers.
$29.65 - $33.92
21% of jobs
The median wage is $37.38 / hr.
$33.92 - $38.20
23% of jobs
$38.20 - $42.47
13% of jobs
$45.79 is the 75th percentile. Wages above this are outliers.
$42.47 - $46.74
10% of jobs
$46.74 - $51.01
8% of jobs
$51.01 - $55.28
5% of jobs
$55.28 - $59.55
5% of jobs
$59.55 - $63.82
2% of jobs
$63.82 - $68.09
2% of jobs
$21
$41
$68
How much do part time utilization review jobs pay per hour?
How to make an extra 2000 a month as a nurse?
How to get a utilization review job?
What is a Part Time Utilization Review job?
What are some common challenges faced in a part-time utilization review role and how can I effectively manage them?
Is utilization review a stressful job?
What is the difference between Part Time Utilization Review vs Part Time Case Management?
| Aspect | Part Time Utilization Review | Part Time Case Management |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications (e.g., RN, LPN, or medical reviewer credentials) | Often requires social work, nursing, or healthcare certifications, with some overlap |
| Work Environment | Healthcare facilities, insurance companies, or third-party review organizations | Hospitals, insurance companies, or community health agencies |
| Employer & Industry Usage | Used mainly in insurance and healthcare to evaluate medical necessity | Used in healthcare to coordinate patient care and services |
Part Time Utilization Review focuses on assessing the medical necessity of services, while Part Time Case Management involves coordinating patient care and services. Both roles require healthcare credentials and are common in insurance and healthcare settings, but they serve different functions within patient care and resource management.
What are the key skills and qualifications needed to thrive as a Part Time Utilization Review Nurse, and why are they important?
What jobs pay 4000 a week without a degree?
- Remote Utilization Management Pharmacist
- Cvs Health Utilization Management
- Remote Clinical Appeals Specialist
- Flex Schedule Remote Utilization Review Nurse
- Remote Case Reviewer
- Evening Optum Health Utilization Review
- Temporary Utilization Review Nurse
- Utilization Review Physician
- Behavioral Health Utilization Review
- Full Time Appeals Nurse Remote
- Care Review Processor Molina
- Concurrent Review
- Cigna Utilization Review Remote
- Authorization Utilization Review Bcba
- Psychiatric Utilization Review
- Free Utilization Review Training
- Anthem Utilization Review Nurse
- Internship Rn Utilization Review Nurse
- Contract Utilization Review
- Utilization Review Case Manager

Associate Medical Director, Physician Advisor for Utilization Management
Los Angeles, CA • On-site
Full-time, Part-time
Re-posted 21 days ago
Cedars-Sinai rating
8.6
Based on 130 frontline employees who took The Breakroom Quiz
37th of 1,020 rated hospitals
Job description
Overview:
The Associate Medical Director, Physician Advisor supports Utilization Management by providing clinical oversight, education, and guidance on medical necessity, Centers for Medicare and Medicaid Services (CMS) compliance, documentation, and resource utilization. This role partners with medical staff, hospital leadership, and payers to promote appropriate patient status, optimize length of stay, and ensure high-quality, cost-effective care. As a key member of the hospital's Utilization Review Committee (URC), the Physician Advisor conducts case reviews and helps drive compliance with regulatory standards while improving clinical and operational efficiency.
Responsibilities:
This is meant to be a general list of responsibilities, not an exhaustive list. The breadth of responsibilities is large; focus on the individual responsibilities below will vary depending upon evolving organizational priorities. The Associate Medical Director and Physician Advisor will also perform other reasonably related business/job duties as assigned. Cedars-Sinai Medical Center reserves the right to revise job duties and responsibilities as the need arises.
Utilization Management
- Review referred medical records for quality, utilization, patient status, medical necessity, and provision of services.
- Collaborate with Utilization Managers, Care Management, attending and consulting physicians regarding level of care, continued stay, length of stay, alternative levels of care, resource utilization, and complex clinical issues.
- Serve as a liaison between physicians and Utilization Management staff to ensure inpatient hospitalizations meet medical necessity criteria.
- Participate in the hospital Utilization Review Committee and support optimization of utilization management workflows with Physician Advisors and leadership.
- Perform Medicare short-stay reviews for potential Medicare Part B re-billing.
- Serve as the hospital expert on patient status determinations for all payers.
- Recommend additional medical record documentation to support medical necessity.
- Support delivery of Medicare Advanced Beneficiary Notices (ABNs), Hospital-Issued Notices of Noncoverage (HINNs), or other patient notices regarding patient financial responsibility.
Denial Management
- Prepare for and participate in payer medical director peer-to-peer discussions.
- Maintain effective working relationships with payer medical directors.
Quality
- Collaborate on quality, safety, efficiency, and readmission reduction initiatives surrounding Utilization Management
- Support organizational quality improvement efforts requiring clinician involvement.
Education
- Maintain knowledge of current state, federal, and CMS regulations, Quality Improvement Organization (QIO) requirements, and guidelines on utilization review.
- Educate providers on payer and CMS requirements, Inpatient status designations, medical necessity, documentation standards, utilization of hospital services, and alternative levels of care through meetings, presentations, newsletters, and other communications.
- Report practice pattern trends and improvement opportunities.
- Support effective communication with inpatient clinical leadership.
Administrative
- Report to the Cedars-Sinai Medical Center Medical Director of Utilization Management and collaborate with Utilization Management and Revenue Cycle leadership.
- Participate in routine meetings with Utilization Managers to review trends, education, escalation issues, and feedback.
Key Performance Indicators (KPIs)
- Support inpatient secondary reviews without final medical necessity denial.
- Complete patient status escalation reviews within four (4) hours.
- Maintain routine attendance at Utilization Review Committee meetings.
- Complete initial assessment of Medicare short-stay escalations within seven (7) business days.
Requirements:
- Licensed physician (MD/DO/MBBS).
- Holds (or is able to obtain) a medical license in good standing in the State of California.
- At least three (3) years of experience in clinical practice, preferably in an inpatient hospital setting.
- This position may be filled on a full-time or part-time basis, with a minimum commitment of 0.5 FTE
- The position includes shared coverage responsibilities, including some weekends and holidays, on a rotating basis with other Physician Advisors/physicians
- Maintains current knowledge of state, federal, and payor regulatory and contract requirements along with familiarity in quality and utilization management topics via yearly continuing medical education programs and self-study.
- American College of Physician Advisors Certified (ACPA-C) within six (6) months of hire if not already attained (preferred).
- Well versed in the use of InterQual and MCG criteria (preferred)
- Well versed in the use of Epic electronic health record (preferred)
- Exceptional organization and time management skills.
- Demonstrates the skills and competencies necessary to perform the assigned job determined through on-going skills, competency assessments, and performance evaluations.
- Ability to communicate effectively in both oral and written.
- Ability to effectively communicate with physicians and other staff.
- Ability to foster positive relations and work effectively with all disciplines within the hospital setting.
Cedars-Sinai Medical Center is one of the largest and fastest-growing nonprofit academic medical centers in the U.S., with 886 licensed beds, 2,100 physicians, 2,800 nurses, and thousands of other healthcare professionals, faculty and staff. We are in a highly desirable location in the City of Los Angeles. Competitive salary, benefits and relocation support will be provided.
Our compensation philosophy
We offer competitive total compensation that includes pay, benefits, and other incentive programs for our employees. The total pay range shown above takes into account the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This total pay range includes any incentive payments that may be applicable to this role. We also offer a comprehensive faculty benefits package. Pay Range: $250,000-410,000 total cash compensation.
What Cedars-Sinai employees say
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About Cedars-Sinai
Sourced by ZipRecruiter
Industry
Hospitals, outpatient health care and health care and social assistance
Company size
10,000+ Employees
Headquarters location
Los Angeles, CA, US