Clinical Utilization & Quality Improvement Leader

3110 Kennestone Hospital, Inc.; United States; On-site; USD 180,000 - 240,000; Full time

Job summary

Wellstar is seeking a Physician Advisor to impact quality, utilization, patient satisfaction, and efficiency through performance improvement and education initiatives. You will collaborate with the CMO and Care Coordination teams to review cases for medical necessity and appropriate levels of care, drive readmission reduction, and support regulatory requirements.

The role involves real-time feedback to physicians, case managers, and staff; leading complex care rounds; and facilitating

Qualifications

• Doctorate in medicine (MD/DO) required; board certified preferred.
• MBA or MPH/MA in Health Admin preferred for leadership roles.
• Excellent communication and organizational skills required.

Responsibilities

• Guide utilization management and ensure medical necessity and appropriate levels of care.
• Lead readmission reduction initiatives and care coordination efforts.
• Collaborate with physicians and hospital leadership on performance improvement initiatives.
• Provide expert clinical review and documentation guidance across care pathways.

Skills

Communication

Leadership

Time management

Analytical skills

Education

MD/DO

MBA/MS in Health Admin

Job description

Wellstar is seeking a Physician Advisor to impact quality, utilization, patient satisfaction, and efficiency through performance improvement and education initiatives. You will collaborate with the CMO and Care Coordination teams to review cases for medical necessity and appropriate levels of care, drive readmission reduction, and support regulatory requirements.

The role involves real-time feedback to physicians, case managers, and staff; leading complex care rounds; and facilitating