Care & Utilization Leadership Physician Advisor

ACPM; City of White Plains (NY); On-site; USD 180,000 - 260,000; Full time

Job summary

White Plains Hospital in White Plains, NY seeks an experienced Care Management & Utilization Management Physician Advisor to provide clinical leadership across care management, utilization management, CDI, coding, quality, and patient safety. This full-time role drives high-value, evidence-based care and ensures regulatory compliance while guiding hospital operations.

You will partner with interdisciplinary teams to optimize admission decisions, documentation accuracy, and transitions of care,

Qualifications

• MD/DO from an accredited medical school.
• Current, unrestricted New York State medical license.
• Board certification in a medical specialty.
• Minimum of 10 years of clinical practice with progressive physician leadership experience.
• Hospital-based or inpatient clinical experience preferred.
• Experience in Physician Advisory, Care Management, Utilization Management, CDI, Coding, Quality, Patient Safety, or hospital operations preferred.
• Experience with medical necessity, inpatient/observation status, payer peer-to-peer reviews, denials and appeals preferred.
• Experience with multidisciplinary performance improvement and physician engagement.

Responsibilities

• Provide physician leadership and clinical guidance across Care Management, Utilization Management, CDI, Coding, Quality, Patient Safety, and hospital operations.
• Support admission status decisions and level of care determinations.
• Participate in payer peer-to-peer reviews, denials, appeals, and complex case escalations.
• Collaborate with CDI and Coding teams to support accurate documentation and coding.
• Improve care progression, length of stay, transitions of care, and discharge planning.
• Identify opportunities to improve quality, patient safety, and resource utilization.
• Educate and engage physicians on documentation, utilization, medical necessity, and regulatory requirements.
• Lead multidisciplinary performance-improvement and physician engagement initiatives.

Skills

Physician leadership

Interdisciplinary collaboration

Regulatory compliance

Data-driven decisions

Influencing physicians

Education

MD/DO

New York medical license

Board certification

Tools

None

Job description

White Plains Hospital in White Plains, NY seeks an experienced Care Management & Utilization Management Physician Advisor to provide clinical leadership across care management, utilization management, CDI, coding, quality, and patient safety. This full-time role drives high-value, evidence-based care and ensures regulatory compliance while guiding hospital operations.

You will partner with interdisciplinary teams to optimize admission decisions, documentation accuracy, and transitions of care,