Tipo de Contrato: Tiempo Completo Salario: $23,000
We are seeking a Bilingual Physician with strong clinical knowledge and exceptional communication skills to support our healthcare management operations. This role involves providing medical oversight in areas such as admissions review, case management, discharge planning, and utilization review. You will play a key part in ensuring appropriate healthcare delivery and compliance with medical necessity and reimbursement guidelines.
Key Responsibilities:
Evaluate admission and service requests (prospective, concurrent, and retrospective) for medical necessity and policy compliance.
Act as a liaison between attending physicians and physician advisors to align on care plans and documentation requirements.
Support case management and discharge planning by offering clinical input and guidance.
Document denial information and resolution efforts in the electronic medical record (EMR) system.
Ensure payor communications and medical necessity justifications are properly documented and scanned into the system for appeals.
Consult with medical teams on diagnoses, treatment length, and case documentation.
Participate in utilization review and peer review meetings and projects as assigned.
Requirements:
Medical degree / Licensed Physician
6 months to 1 year of clinical or hospital experience.
Bilingual proficiency – excellent English communication (written and spoken).
Knowledge of utilization management, reimbursement policies, and healthcare documentation standards is preferred.
Proficiency in using electronic medical records (EMRs) and clinical case management systems.
Strong analytical, problem-solving, and decision-making skills.
Availability to work Tuesday to Saturday, 7 am to 4:36 pm
On-site job (Torre Meya, close to Plaza del Sol)*
Join our team and contribute to improving healthcare delivery through smart clinical insights and effective coordination. This is an excellent opportunity for physicians looking to transition into a non-bedside, administrative, or hybrid clinical role with high impact.
