About the Role
This position involves leading physician advisory services, focusing on optimizing patient care workflows, improving documentation practices, and supporting clinical teams in achieving regulatory and quality benchmarks.
Responsibilities
- Lead and mentor a team of physician advisors
- Collaborate with care management and case management departments
- Review clinical documentation for completeness and accuracy
- Support appropriate patient placement and length of stay
- Ensure compliance with payer-specific admission criteria
- Participate in interdisciplinary utilization management rounds
- Advise on clinical validation and query processes
- Assist in resolving denials and appeals related to medical necessity
- Work with coding and compliance teams to improve data integrity
- Promote adherence to evidence-based clinical guidelines
- Monitor key performance indicators for utilization metrics
- Provide feedback to clinicians on documentation opportunities
- Serve as a liaison between clinical staff and administrative leadership
- Contribute to policy development in care coordination
- Support quality improvement initiatives
- Participate in peer review and physician education
- Maintain current knowledge of regulatory standards
- Engage in data analysis to identify trends in utilization
- Facilitate communication between departments
- Promote a culture of accountability and clinical excellence
Compensation
Competitive salary and comprehensive benefits package
Work Arrangement
Onsite with potential for limited remote collaboration
Team
Integrated within care management and clinical operations teams
About the Organization
A regional healthcare network serving communities across Connecticut and New York, delivering high-quality, patient-centered care through a network of hospitals, outpatient centers, and physician practices.
Why This Role Matters
This position plays a critical role in aligning clinical decision-making with regulatory requirements, enhancing revenue integrity, and supporting seamless patient care transitions.
Not available