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)*
Pay: $23,000.00 per month
License/Certification:
- Medical Degree and license (preferred)
Work Location: In person

📌 Lic en Medicina (Zapopan)
🏢 Intugo
📍 Zapopan