Physician Advisor

Mount Sinai Hospital; Hempfield Township (Westmoreland County); On-site; USD 180,000 - 280,000; Full time

Job summary

Mount Sinai Hospital is seeking a full-time Physician Advisor to support hospital utilization, including provider practice patterns, resource use, and medical necessity decisions.

The role requires an MD or DO, board certification, NY license, DEA and Medicaid numbers, and at least five years of practice. Strong skills in Excel, Epic, and WebEx, with knowledge of MCG/Interqual, are preferred.

Qualifications

• MD/DO degree required and board-certified in the physician's specialty.
• Must hold a valid New York State medical license along with a DEA and Medicaid number.
• Five years of medical practice experience required; willingness to work clinically in the primary specialty.
• Experience in utilization management, quality improvement, and case management operations beneficial.
• Familiarity with MCG and Interqual criteria and strong computer skills are expected.

Responsibilities

• Serve as the primary physician liaison for hospital utilization and resource use.
• Address provider practice patterns, over- and under-utilization, and medical necessity decisions.
• Oversee levels of care, care progression, length of stay management, and denial management.
• Ensure compliance with governmental and private payer regulations and coding requirements.

Skills

Utilization management

Quality improvement

Clinical leadership

Microsoft Excel

Epic

Cisco WebEx

Education

MD or DO degree

Board-Certified in specialty

Tools

Microsoft Excel

Epic

Cisco WebEx

Job description

Physician Advisor

The Icahn School of Medicine at Mount Sinai through its affiliation with New York City Health + Hospitals/Queens is seeking a full-time Physician Advisor to assist with the hospital’s goals and objectives for ensuring effective use of health care resources. The Physician Advisor serves as the primary physician liaison for issues pertaining to hospital utilization, including matters pertaining to provider practice patterns, over- and under-utilization of resources, medical necessity, levels of care, care progression and length of stay management, denial management, and compliance with governmental and private payer regulations, physician documentation and coding requirements.

Candidates must have an MD or DO degree and be Board-Certified in their respective specialty, with a valid New York State License, DEA and Medicaid number. Must also be willing to work clinically in their primary specialty. A minimum of five years medical practice experience is required. Qualified candidates should possess a solid foundation, knowledge and/or experience in utilization management and quality improvement; acquire knowledge of NYC Health + Hospitals’ case management operations; acquire strong familiarity with MCG and Interqual medical necessity criteria; and possess strong computer skills, including proficiency in Microsoft Excel, Epic, and Cisco WebEx. Compensation is competitive and will vary based on specialty, experience, and qualifications.

The Mount Sinai Health System (MSHS) provides equal employment opportunity to all its employees and applicants for employment without unlawful discrimination on the basis of their actual or perceived race, creed, color, religion, national origin, sex, gender, gender expression, gender identity, age, disability, marital or parental status, sexual orientation, veteran, immigration, citizenship, or other protected status.

EOE including Veterans and Disabled