Physician Advisor (Hospital Medicine)

Quick Facts

• Role: Physician Advisor (Hospital Medicine)

• Specialty focus: Internal Medicine

• Key partners: Case Management (CM), Clinical Documentation Improvement (CDI), medical staff, and payer-facing stakeholders

Description

The Physician Advisor advises, educates, and supports hospital teams through teaching, consulting, and case-management/clinical documentation review. The role focuses on compliant inpatient admissions and observation status, appropriate continued stay decisions, utilization review, and medical necessity. It includes conducting peer-to-peer reviews and appeals, providing feedback to treating physicians, and supporting quality improvement activities.

Responsibilities

• Promote compliance with CMS, state, and payer policies for inpatient admissions, observation status, and appropriateness of continued hospital stay

• Facilitate communication between payers and providers regarding benefit coverage issues, denials, utilization review, and quality assurance processes

• Lead/participate in quality improvement activities in alignment with state/federal and accreditation requirements

• Conduct verbal and written reviews (including peer-to-peer) and appeals for denied or downgraded payer coverage determinations

• Provide feedback to attending physicians and consultants on appropriate level of care, length of stay, and quality issues

• Request additional clinical information and ensure documentation supports utilization and adherence to regulatory/compliance requirements

• Review medical records referred by care management for level of care determination, length of stay management, denial management, and alignment with MCG criteria or other recognized quality standards

Requirements

• Board-certified Internal Medicine physician

• 7+ years of experience as an internal medicine or sub-specialty physician

• Demonstrated ability to build consensus with physicians and leadership

• Excellent interpersonal and communication skills

Benefits

• Competitive compensation including income guarantee and bonus incentives

• Generous start-up and retention bonuses; relocation allowance

• Paid malpractice

• 27 days of Allowed Time Off plus five additional paid CME days with annual stipend

• Full benefits package: health, life, dental, vision, and legal insurance

• Retirement options: 403(b), 457(b), 401(a)

• Short- and Long-Term Own Occupation Disability

• Customized marketing support

• Leadership development through board and committee opportunities