Physician Advisor

PAGNY; New York (NY); On-site; USD 241,000 - 246,000; Full time

Benefits offered by this job

401(k) company contributions

CME reimbursement

Paid time off

Health and dental coverage

Job summary

PAGNY, in collaboration with NYC Health + Hospitals/Kings County, seeks a Physician Advisor for Clinical utilization in Brooklyn. The role supports denial management, utilization review, and education across clinical teams to align with payer requirements and regulatory standards.

The position emphasizes collaboration with ED, case managers, and physicians, with a strong focus on documentation improvement and quality metrics within a large municipal health system.

Qualifications

• Board-certified or board-eligible in Internal Medicine.
• Licensed to practice in New York.
• 1–2 years of physician advisor experience.

Responsibilities

• Support the denial management and appeal process with clinical analysis and documentation review to strengthen submissions.
• Identify denial trends, perform root-cause analysis, and implement prevention strategies including physician education on documentation and ICD-10 alignment.
• Collaborate with Emergency Department to reduce denial risk by improving level-of-care documentation at entry.
• Develop and deliver education on utilization management principles, regulatory expectations, and payer requirements in collaboration with Compliance and Revenue Cycle leadership.
• Review medical records to support utilization management processes and escalate clinical questions to licensed clinicians as appropriate.

Skills

Clinical analysis

Denial management

Communication with payors

Utilization management

Education

Board Eligible or Board Certified in Internal Medicine

Tools

ICD-10 coding

Job description

Position type: Full-Time

Department: Internal Medicine

Location: NYC Health + Hospitals/Kings County, 451 Clarkson Avenue Brooklyn, NY 11203

Salary range: $241,000-246,000

Description

Physician Affiliate Group of New York (PAGNY) is adding a Physician Advisor to the group at NYC Health + Hospitals/Kings County. Kings County Hospital operates a world-renowned Level I Trauma Center, one of only three in Brooklyn, which serves 2.6 million residents of Brooklyn and Staten Island. The hospital maintains a strong academic affiliation with SUNY Downstate Health Sciences University to maintain its high healthcare delivery standards.

The Mission of NYC Health + Hospitals is to extend equally to all New Yorkers, regardless of the ability to pay, comprehensive health services of the highest quality in an atmosphere of humane care, dignity, and respect. Their Values are built on a foundation of social and racial equity and have established the ICARE standards for all staff.

NYC Health + Hospitals is the nation's largest municipal healthcare delivery system in the United States. Dedicated to providing the highest quality health care services to all New Yorkers with compassion, dignity and respect, regardless of immigration status or ability to pay.

Opportunity Details:

The Department of Medicine at Kings County is seeking a full-time Physician Advisor for Clinical utilization.

• Support the denial management and appeal process by providing clinical analysis and documentation review to strengthen appeal submissions. Will take part in Peer to peer discussions with payors for denial prevention.
• Identify denial trends, perform root cause analysis, and implement targeted prevention strategies, including physician education on documentation best practices and alignment with ICD-10 coding and medical necessity criteria.
• Collaborate with ED to address front-end drivers of denial risk by reducing avoidable admission and observation cases and improving level-of-care documentation at the point of entry.
• Develop and deliver education to physicians and clinical teams on utilization management principles, documentation improvement, regulatory expectations, and payer requirements, in collaboration with Compliance, CDI, and Revenue Cycle leadership.
• Familiarize physicians, as well as case managers, with MCG and inter-Qual criteria for both admissions and documentation
• Participate in performance improvement projects at Kings County, as well as other programs for the system.
• Review medical records and clinical documentation to support utilization management processes, identifying opportunities for alignment with regulatory requirements, payer guidelines, and organizational standards. Escalate clinical questions to licensed clinicians as appropriate, and participate in organizing the Utilization Review Committee.
• Work closely with physicians, nurses, case managers, administrators, and other stakeholders to foster effective communication, alignment, and consistency across utilization management and care coordination workflows.
• Contribute to the development, review, and refinement of utilization management policies, protocols, and workflows, ensuring alignment with regulatory standards and organizational goals.
• Consults with other members of the professional staff, give guidance, advise, or professional medical opinion to less experienced members of the professional medical staff, the house staff and other members of the health care team, provide instruction for Medical Students rotating in the Department and participate in any other customary activities under the usual standard of medical practice as necessary.

Qualifications

• Board Eligible or Board Certified in Internal Medicine
• Licensed to practice in the State of New York
• 1-2 years of prior Physician Advisorexperience

Wages and Benefits include:

Annual Base Salary: $241,000* (board eligible); $246,000* (board certified) based on 40-hour work week. Additional compensation available for sessional/per diem hours.

The annual total value of the compensation package is estimated at $320,620** (board eligible) and $326,120** (board certified) which includes the baseline salary, 401(k) contribution, sessional/per diem hours, and other factors as set forth below:

• Estimated annual compensation for 10 additional sessional/per diem hours worked per week is $55,520.
• 401(k) Company Contribution (subject to IRS contribution limits):
  • Employees are immediately vested in a 3% company contribution of base earnings. No employee match is required.
  • After one year of service, employees receive an additional 7% company contribution of base earnings. No employee match is required.
• Annual Continuing Medical Education (CME) Reimbursement.
• Generous Annual Paid Time Off (PTO): Vacation, Sick, Holiday, and CME days.
• Medical, Prescription, and Dental Coverage: Top-tier plans with employee contributions significantly below market rates.
• Life Insurance and Accidental Death and Dismemberment (AD&D) Coverage: Equal to 2x your salary (up to a maximum of $300,000) provided at no cost to you.
  • Additional employee-paid Voluntary Life and AD&D coverage is available for you and your family.
• Loan Forgiveness: Position may be eligible for loan forgiveness through certain state or federal programs.
• Medical Malpractice Coverage (equivalent to occurrence-based): Provided at no cost to the employee.
• Healthcare and Dependent Care Flexible Spending Accounts (FSAs).
• Pre-tax employee-paid contributions for commuting expenses.
• Visa sponsorship will be considered for this position.

Physician Affiliate Group of New York, P.C. (PAGNY) mission is to provide accountable, responsive, quality care with the highest degree of sensitivity to the needs of the diverse population that lives in our New York community. PAGNY is one of the largest physician groups in the country and directly employsnearly 4,000physicians and allied health professionals who provide services to NYC Health + Hospitals, the largest municipal health care system in the nation,serving more than a million New Yorkers annually.Our providers are highly skilled professionals with outstanding credentials who deliver the highest level of quality healthcare to patients throughout New York City.

Physician Affiliate Group of New York, P.C. (PAGNY) is an equal opportunity employer committed toequitablehiring practices and a supportive workplace. All candidates are considered based on their individual qualifications, potential, and experience. Tolearnmore about our culture and ongoing workplace practices, please visitourWorkplace Culture | PAGNY page.

*Salary Disclosure Information:

The salary listed for this position complies with New York City's Salary Transparency Law for Job Advertisements. The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, or benefits. Actual total compensation may vary based on factors such as experience, skills, qualifications, historical performance, and other relevant criteria.

**The annual total value of the compensation package shown is provided as an illustration and is not guaranteed.