Physician Advisor

AdventHealth; Town of Florida (NY); On-site; USD 207,000 - 413,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

Life Insurance

Disability Insurance

Paid time off from day one

403-B retirement plan

Parental leave

Career development

Well-being resources

Mental health resources

Pet benefits

Job summary

AdventHealth in Altamonte Springs, FL is seeking a Physician Advisor to educate and advise Utilization Management, HIM, Revenue Cycle, Patient Access, Managed Care teams on updates and trends related to utilization and denial prevention.

The role provides physician‑level review of utilization, claims management, and quality assurance for inpatient, outpatient/observation, and referral services. It serves as a key clinical liaison and helps promote high‑quality, cost‑effective care.

Qualifications

• MD or DO with active medical license and board certification.
• 5+ years of recent clinical practice experience.
• 2+ years or greater as Physician Advisor (preferred).
• 3+ years of leadership experience (preferred).
• Strong communication, analytical, and problem‑solving abilities.
• Ability to work in a matrix‑management environment and educate staff.

Responsibilities

• Reviews and authorizes inpatient days, evaluates utilization patterns, and ensures appropriate determinations.
• Collaborates with Utilization Management on case reviews and process improvements.
• Acts as clinical liaison with attending physicians and medical staff for decision‑making and documentation.
• Partners with managed care payers on denials, appeals, and utilization criteria.
• Analyzes data to identify utilization improvements and monitor outliers.
• Educates physicians and clinical teams on UM protocols and regulatory changes.
• Reviews payer denials and supports denial prevention strategies.
• Participates in Utilization Management and hospital committees, supporting quality initiatives.
• Supports organizational goals for length of stay, quality, and resource stewardship.
• Performs other duties as assigned.

Skills

Relationship building

Clinical practice

Organization

Analytical skills

Communication

Matrix management

Policy interpretation

Medical advice

Microsoft Office

Health plan experience

Education

Doctorate

Master's degree (preferred)

Tools

Outlook

Word

Excel

PowerPoint

Job description

Our Promise To You

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose‑minded team. All while understanding that together we are even better.

Our Promise To You

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose‑minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance
• Paid Time Off from Day One
• 403-B Retirement Plan
• 4 Weeks 100% Paid Parental Leave
• Career Development
• Whole Person Well-being Resources
• Mental Health Resources and Support
• Pet Benefits

Schedule

Full time

Shift

Day (United States of America)

Address

601 E ALTAMONTE DR

City

ALTAMONTE SPRINGS

State

Florida

Postal Code

32701

Job Description

Location: Full-time, onsite, Monday–Friday, 8:00 a.m.–5:00 p.m.

Location: Altamonte - 601 E Altamonte Dr, Altamonte Springs, FL 32701

The Physician Advisor educates and advises Utilization Management, HIM, Revenue Cycle, Patient Access, Managed Care teams, and medical staff on updates and trends related to utilization and denial prevention. The role provides physician-level review of utilization, claims management, and quality assurance for inpatient, outpatient/observation, and referral services. It supports Chief Medical Officer functions across the region to ensure high‑quality, efficient care throughout the continuum and serves as a key contact for clinicians, payers, external providers, and regulatory entities. The Physician Advisor acts as a subject matter expert, offering clinical and business guidance to promote high‑quality, patient‑focused, cost‑effective care while maintaining respectful, collaborative relationships.

• Reviews and authorizes inpatient days, evaluates utilization patterns, and ensures appropriate inpatient/outpatient determinations.
• Works closely with Utilization Management staff on process improvement, case reviews, and continuity of care efforts.
• Serves as a clinical liaison with attending physicians and medical staff to support decision‑making and accurate documentation.
• Collaborates with managed care payers and their medical directors on denials, appeals, and utilization criteria.
• Analyzes data and trends to identify utilization improvement opportunities, develop benchmarking, and monitor outliers.
• Provides education to physicians and clinical teams on UM protocols, regulatory changes, and documentation requirements.
• Reviews concurrent and post-acute payer denials, intervenes with providers and payers, and supports denial prevention strategies.
• Participates in Utilization Management and hospital committees, sharing trends and supporting quality and operational initiatives.
• Supports organizational goals related to length of stay, quality, responsible resource stewardship, and overall performance.
• Performs other duties as assigned.

Knowledge, Skills, And Abilities

• Strong ability to build and sustain relationships in the medical community and a corporate environment [Required]
• Successful history as a practicing physician [Required]
• Strong organization skills with attention to detail [Required]
• Excellent analytical and problem‑solving skills [Required]
• Effective oral and written communication skills, with the ability to articulate complex information in understandable terms to all levels of staff [Required]
• Ability to work in a matrix‑management environment to achieve organizational goals [Required]
• Ability to translate ethical and legal requirements into practical and sustainable policies, balancing the needs of the business and the interest of patients and member physicians alike [Required]
• Ability to provide expert medical advice and explain complex medical situation [Required]
• Health plan experience in operations [Preferred]
• Experience in a physician group model, leadership experience [Preferred]
• Effective computer skills, particularly Microsoft Office Outlook, Word, Excel, PowerPoint [Preferred]

Education

• Doctorate [Required]
• Master's [Preferred]

Field Of Study

• Graduate of an accredited Medical School
• in Business or Healthcare Administration

Work Experience

• 5+ years recent clinical practice experience [Required]
• 2+ years or greater experience as a Physician Advisor [Preferred]
• 3+ years of leadership experience [Preferred]

Licenses And Certifications

• Medical Doctor (MD) [Required] OR Doctor of Osteopathic Medicine (DO) [Required]
• Basic Life Support (BLS) [Preferred]

Physical Requirements:

• Physical Requirements - https://tinyurl.com/23km2677

Pay Range

$206,606.17 - $413,212.34

Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening, including fingerprinting, as required by state law. Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti‑discrimination laws, regulations and ordinances.