Physician Advisor, Physician Advisor

Physician Advisor – Utilization Review & Case Management

Location : Guadalajara, Mexico (On-site)

Schedule :

Training Period : Monday to Friday, 7 : 00 AM – 4 : 30 PM

Post-Training : May shift to Tuesday to Saturday, 7 : 00 AM – 4 : 30 PM

Job Type : Full-time

Compensation : Competitive salary + Annual performance-based bonus

Benefits : Standard industry benefits

About the Role

We are seeking a licensed Physician to join our growing team in Guadalajara . This role is focused on utilization review, case management, discharge planning , and providing clinical support for reimbursement-related activities.

As a physician in this position, you will work closely with multidisciplinary teams to ensure quality care delivery, compliance with policies, and optimized patient outcomes. You’ll be a vital part of a collaborative and supportive environment that values excellence, integrity, and client satisfaction.

Key Responsibilities

Deliver healthcare services related to admissions, discharge planning, utilization review , and case management .

Evaluate medical necessity and policy compliance for prospective, concurrent, and retrospective reviews.

Assist with medical documentation , coding issues, precertification, reimbursement, and appeals / denials.

Notify care teams of denials, inappropriate admissions , and other reimbursement-impacting factors.

Collaborate with attending physicians to ensure accurate clinical documentation .

Act as a liaison between attending physicians and Physician Advisors.

Document all denial-related activity in the EMR and ensure payor communications are properly recorded.

Communicate effectively with payors, providers, patients / families , and external agencies.

Consult on patient diagnosis, medical justification, treatment duration, and case notes.

Participate in peer review and utilization meetings and contribute to improvement initiatives.

Required Qualifications

Doctorate in Medicine (MD)

Active medical license in Mexico

Fluency in English (written and spoken) is essential

Experience in utilization review, case management, or hospital administration is a plus

Skills & Competencies

High level of integrity and ethical standards

Detail-oriented with strong analytical skills

Excellent time management and ability to multitask

Strong interpersonal and team collaboration skills

Client-focused mindset with a passion for quality care

Ability to navigate and comply with regulatory frameworks