R1 RCM logo
R1 RCM

Technology-driven revenue cycle management services for healthcare providers.

Payer Peer to Peer Physician Advisor

ConsultantConsultantFull TimeRemoteMid LevelTeam 10,001+Since 2017H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

1 day ago

Salary

$150.1K - $199.1K / year

Seniority

Mid Level

No structured requirement data.

Job Description

Payer Peer to Peer Physician Advisor

R1 RCM

Role Description As our Physician Advisor, you will help our client facilities navigate the path to compliant revenue by reviewing payor peer-to-peer cases. Every day, you will: - Review cases for which authorization has been denied, evaluating if the proper documentation was available for the admission status, procedure, and care setting that was requested. - Advise our clients regarding the appropriateness of the request based on available documentation. - Discuss the cases with medical directors from the payor side. To thrive in this role, you must have strong clinical knowledge across multiple clinical areas and be capable of working independently with a high level of performance in a rapidly changing, fast-paced environment. Proficiency in basic computer skills is essential for excelling in this remote position. Here’s what you will experience working as a Physician Advisor: - Address issues such as authorization requested, documentation support or lack of support for that authorization, evidence-based criteria for that support, and complex clinical evaluation of the request as a whole. - Review and respond to the payor and customer in a timely manner. - Actively engage with payor medical directors to discuss appropriate authorization status as supported by documentation. - Provide written analysis of the case and perform case reviews across multiple specialties. - Serve as a clinical resource to medical and case management staff by providing identification, facilitation, and resolution of documentation and utilization issues. Qualifications - Active, unrestricted MD or DO medical licensure - Minimum 3+ years of clinical experience post-residency completion Requirements - This US-based position has a base pay range of $150,075.00 - $199,070.29 per year. Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. - This job is eligible to participate in our annual bonus plan at a target of 10.00%. Benefits - Competitive benefits package.

Related Categories

Related Job Pages

More Consultant Jobs

Full TimeRemoteTeam 10,001+Since 1931H1B Sponsor

• Support the onboarding process for candidates interested in joining GHRN • Engage with candidates through proactive follow-up outreach • Respond to inbound inquiries from individuals seeking information or assistance • Guide qualified gig-work candidates through the onboarding journey • Assess candidate roadside assistance tools and equipment • Coordinate and schedule skills validation appointments

United States
$53.5K - $84.6K / year
Full TimeRemoteTeam 201-500H1B No Sponsor

• Lead end-to-end implementations of Caseware accounting and assurance solutions, including requirements gathering, solution design, configuration, testing, training and go-live support. • Act as the primary solution authority for assigned client engagements, providing expert guidance on Caseware functionality, best practices, and accounting workflow optimization. • Translate client business and regulatory requirements into scalable, compliant Caseware configurations, ensuring alignment with applicable accounting standards and firm methodologies. • Manage client relationships, serving as a trusted advisor to customer stakeholders throughout the implementation lifecycle. • Oversee project execution and delivery quality on non-enterprise projects, including scope control, risk identification, issue resolution, and adherence to timelines, budgets, and service standards. • Collaborate cross-functionally with Product, Support, and Engineering teams to escalate issues, contribute to product feedback, and ensure successful client outcomes. • Mentor and provide technical leadership to associate consultants and implementation team members, including knowledge sharing, solution reviews, and delivery oversight. • Deliver client training and change management activities, enabling user adoption, process transformation, and long-term value realization from Caseware solutions. • Support pre-sales and solution scoping activities by contributing to proposals, solution demonstrations, effort estimation, and implementation approach definition. • Continuously improve implementation methodologies and assets, leveraging lessons learned, industry trends, and evolving Caseware capabilities to enhance service delivery effectiveness.

United States

Metrics and Data Consultant

SAIC

SAIC® is a premier mission integrator focused on advancing the power of technology and innovation to serve and protect our world. Our robust portfolio of offerings across the defense, space, intelligence, and civilian markets includes secure high-end solutions in mission IT, enterprise IT, engineering services, and professional services. We integrate emerging technology, rapidly and securely, into mission critical operations that modernize and enable critical national imperatives. We are approximately 23,000 strong; driven by mission, united by purpose, and inspired by opportunities. SAIC is an Equal Opportunity Employer. Headquartered in Reston, Virginia, SAIC has annual revenues of approximately $7.3 billion. For more information, visit saic.com . For ongoing news, please visit our newsroom .

Consultant1 day ago

Role Description SAIC has an opening for a Metrics and Data Consultant to join our People Analytics Team. This position can be worked remotely, within the U.S., for the right candidate. The Metrics and Data Consultant is the ultimate data storyteller—part analyst, part strategist, part detective. If you enjoy uncovering the hidden truths behind workforce trends and turning them into insights leaders can’t ignore, this role is for you. As a Metrics and Data Consultant, you will transform mountains of workforce data into clear, compelling narratives that shape real business decisions. You'll partner directly with leaders to tackle challenges like retention, engagement, talent gaps, and more—armed with data, curiosity, and just the right amount of storytelling flair. This role combines deep technical skill with strong business intuition. You'll validate complex datasets, refine insights, and ensure that every recommendation is accurate, ethical, and strategically sound. - Strategic Consulting: Work side‑by‑side with business leaders to turn big questions into testable hypotheses, sparking ‘aha’ moments along the way. - Data Modeling: Use advanced analytics and predictive models to identify risks and opportunities in the workforce—and recommend solutions that make a measurable impact. - Data Analysis: Dig deep into data to uncover patterns around attrition, hiring, development, talent management, and employee listening—surfacing insights others might miss. - Narrative Development: Turn validated data into visual stories leaders want to read. You won’t just explain the ‘what’—you’ll illuminate the ‘why’ and ‘what now. - Functional Liaison: Translate business needs into technical requirements so People Analytics builds the right tools at the right time. - Driving Data Culture: Champion easy‑to‑use, self‑service metrics that empower leaders to explore and understand their own data. - Data Validation & Auditing: Serve as the final checkpoint to ensure dashboards and reports are accurate, consistent, and logical across systems. - AI Oversight: Monitor predictive AI outputs—like flight risk or performance models—to ensure insights are unbiased and grounded in reality. - Data Governance: Advocate for ethical data use and protect employee privacy while still delivering meaningful insights. Company Description SAIC® is a premier mission integrator focused on advancing the power of technology and innovation to serve and protect our world. Our robust portfolio of offerings across the defense, space, intelligence, and civilian markets includes secure high-end solutions in mission IT, enterprise IT, engineering services, and professional services. We integrate emerging technology, rapidly and securely, into mission critical operations that modernize and enable critical national imperatives. We are approximately 23,000 strong; driven by mission, united by purpose, and inspired by opportunities. SAIC is an Equal Opportunity Employer. Headquartered in Reston, Virginia, SAIC has annual revenues of approximately $7.3 billion. For more information, visit saic.com . For ongoing news, please visit our newsroom .

United States
Gallagher logo

Senior Retirement Plan Consultant

Gallagher

Working to protect what matters most throughout the world.

Consultant1 day ago
Full TimeRemoteTeam 1,001-5,000Since 1938

Role Description Specializing in providing consulting services to assigned client accounts and is responsible for the day-to-day account management for accounts of moderate to high complexity. Builds, expands, and solidifies relationships with existing clients at all levels within the company. - Has retention goals for assigned group of accounts. - Assesses and prioritizes client needs in a timely manner. - Identifies and helps clients to focus on their most critical needs. - Sets and communicates clear and realistic expectations. - Reviews/approves all key client deliverables. - Works closely with Sales to prepare and negotiate fee-based pricing of services and on the transition of the new clients post the completed sales process. - Anticipates internal and/or external business challenges and/or regulatory issues; recommends process, product or service improvements. - Contributes to the development of functional strategy. - Leads project teams to achieve milestones and objectives. - May supervise day-to-day work of junior level employees, but does not typically have formal management role. Qualifications - Required: Bachelor's degree or equivalent from four-year College or technical school; or five years related experience and/or training; or equivalent combination of education and experience. - 5 years related experience in professional services businesses. - Excellent oral, written communication, organizational skills, negotiation and time management skills. - Experience in defined contribution plan design, governance, compliance, and administration. - Working knowledge of Microsoft Office Suite. - Travel required (25%). - Preferred: Master's degree or professional certification preferred. Requirements - Use of sound judgment of all client interactions. - Exhibits strong ability to anticipate needs and proactively seek to identify new opportunities. - Ability to work under the pressure of deadlines. - High degree of business technology awareness and its applications to workplace efficiencies. - Ability to manage multiple priorities and deadlines. - Effectively handle large, long-term projects as well as manage the details associated with everyday tasks. Benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits. - Medical/dental/vision plans, which start from day one! - Life and accident insurance. - 401(K) and Roth options. - Tax-advantaged accounts (HSA, FSA). - Educational expense reimbursement. - Paid parental leave. - Digital mental health services (Talkspace). - Flexible work hours (availability varies by office and job function). - Training programs. - Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing. - Charitable matching gift program. - And more...

United States