Director of Physician Advisors – Utilization & Quality

Greater Baltimore Medical Center (GBMC); Baltimore (MD); On-site; USD 148,000 - 267,000; Full time

Benefits offered by this job

GBMC Values and Benefits

Job summary

Greater Baltimore Medical Center (GBMC) in Baltimore seeks a Physician Advisor Director to lead a team of associate Physician Advisors supporting case management, utilization review, coding, population health and quality initiatives.

Reporting to the Associate Chief Medical Officer, you will guide policy, oversee procedures, manage denials and appeals, and coordinate with hospital leaders to ensure high‑quality, cost‑effective inpatient and observation care.

Qualifications

• MD degree from an accredited medical program.
• Experience in Utilization Management and Clinical Quality Management.
• Knowledge of Pay for Performance/VBP initiatives.

Responsibilities

• Lead care team reviews for level of care and utilization.
• Collaborate with hospital leaders to align care with evidence-based standards.
• Oversee denial management, appeals, and payer communications.
• Educate clinicians on regulatory requirements and coding guidelines.
• Chairs UM Medical Staff Committee and drives quality initiatives.

Skills

Interpersonal skills

Quality improvement

Regulatory knowledge

Leadership

Education

MD degree

Board Certification (Internal Medicine)

Job description

Greater Baltimore Medical Center (GBMC) in Baltimore seeks a Physician Advisor Director to lead a team of associate Physician Advisors supporting case management, utilization review, coding, population health and quality initiatives.

Reporting to the Associate Chief Medical Officer, you will guide policy, oversee procedures, manage denials and appeals, and coordinate with hospital leaders to ensure high‑quality, cost‑effective inpatient and observation care.