Board-Certified Inpatient Physician Advisor & Utilization Lead

Trinity Health; Iowa; On-site; USD 180,000 - 240,000; Full time

Benefits offered by this job

Paid malpractice insurance

403B retirement match

Job summary

MercyOne Central Iowa is seeking a Physician Advisor to lead the physician-driven resource utilization program, review cases for appropriate level of care, and support clinicians with medical necessity guidance. The role is onsite and collaborates with MercyOne leadership and the broader medical staff.

The ideal candidate will be board-certified with inpatient experience, have strong regulatory knowledge, and promote team-based decision making within a not-for-profit Catholic health system.

Qualifications

• Board-certified physician with inpatient experience.
• Experience serving on hospital committees or strong CMS knowledge.
• Collaborative, team-building mindset and decision making.

Responsibilities

• Lead physician-driven resource utilization program, and work with MercyOne Leadership team to design interventions when necessary
• Review cases to determine appropriate level of care based on medical necessity, and apply regulatory, health plan, and clinical guidelines in the review of denials
• Serve as a resource for physicians regarding medical necessity, level of care, and clinical documentation
• Foster effective communication between members of the care team
• Establish and maintain peer-to-peer protocol

Skills

Inpatient experience

Leadership

Regulatory knowledge

Medical documentation

Education

Board-certified physician

Tools

CMS guidelines

Job description

MercyOne Central Iowa is seeking a Physician Advisor to lead the physician-driven resource utilization program, review cases for appropriate level of care, and support clinicians with medical necessity guidance. The role is onsite and collaborates with MercyOne leadership and the broader medical staff.

The ideal candidate will be board-certified with inpatient experience, have strong regulatory knowledge, and promote team-based decision making within a not-for-profit Catholic health system.