Physician Advisor, Peer to Peer

  • R1
  • Remote
  • Jun 13, 2022
Physician

Job Description

R1 is a leading provider of technology-enabled revenue cycle management services which transform and solve challenges across health systems, hospitals, and physician practices. Headquartered in Chicago, R1 is publicly traded organization with employees throughout the US and international locations.

Our mission is to be the one trusted partner to manage revenue, so providers and patients can focus on what matters most. Our priority is to always do what is best for our clients, patients, and each other. With our proven and scalable operating model, we complement a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience.

The R1 Physician Advisory Team offers a range of services that help navigate the path to compliant revenue.  The Peer-to-Peer team reviews concurrently denied cases to defend with a payor’s medical director. Physicians work to ensure proper classification which increases compliance and reduces the risk of exposure to denials. The Physician Advisor in Peer-to-Peer authors admission status reviews. This team also serves as a clinical resource to medical and case management staff by providing identification, facilitation, and resolution of documentation and utilization issues.

Responsibilities:

  • Addresses the following issues: compliance, level of care, length of stay, and hospital reimbursement for our hospital clients.
  • Review and respond to the customer in a timely manner.
  • Must work during pre-scheduled hours to be high successful in this role (schedules are created 30 days in advance).
  • Participates in clinical discussions in defense of status telephonically with payor.
  • Physicians should be highly capable of working independently with a high level of performance in in a rapidly changing, fast paced environment.
  • Successful physician will need to meet productivity standards.
  • Actively engage with attending physicians to discuss appropriate status as supported by documentation.
  • Make phone contact with utilization review team and/or case managers at client hospitals regarding submitted case determinations.
  • Provide written analysis of the case and perform case reviews across multiple specialties

Required Qualifications:

  • Active, unrestricted MD or DO medical licensure Board certification
  • At least 3 years of experience post-residency, including treatment of inpatients
  • Strong clinical knowledge base across multiple areas
  • Must be computer proficient
  • Strong verbal and written communication skills
  • Must be professional, organized and possess persuasive writing and speaking skills
  • Possess strong negotiating/reasoning/logic and problem-solving skills
  • Must have some flexibility with schedule (minimum of 20/hours week)
  • Weekend work commitment required
  • Ability to work as part of a team Home office that is HIPAA compliant

Desired Qualifications 

  • Basic knowledge of with Interqual, and MCG criteria
  • Previous experience with utilization review or chart review

Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.

Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package including:

  • Comprehensive Medical, Dental, Vision & RX Coverage
  • Paid Time Off, Volunteer Time & Holidays
  • 401K with Company Match
  • Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability
  • Tuition Reimbursement
  • Parental Leave

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.  

To learn more, visit: R1RCM.com

Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests.


Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package including:

  • Comprehensive Medical, Dental, Vision & RX Coverage
  • Paid Time Off, Volunteer Time & Holidays
  • 401K with Company Match
  • Company-Paid Life Insurance, Short-Term Disability & Long-Term Disability
  • Tuition Reimbursement
  • Parental Leave

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

To learn more, visit: R1RCM.com

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