Physician Advisor: CDI & Utilization Lead

Mosaic Life Care; Saint Joseph (MO); On-site; USD 220,000 - 320,000; Full time

Job summary

Mosaic Life Care in Saint Joseph, MO, is seeking a Physician Advisor to lead medical necessity reviews, CDI initiatives, and collaboration with care management, HIM, and revenue cycle teams. The role emphasizes physician-to-physician communication, evidence-based practice, and regulatory compliance to optimize patient care and documentation accuracy.

The candidate will provide expert clinical review, peer-to-peer discussions, and education on documentation specificity, DIAGNOSIS linkage, and DRG

Qualifications

• Current clinical acute care experience; 5 years post residency as attending physician.
• Strong understanding of medical necessity, payer rules, and documentation standards.
• Excellent physician-to-physician communication and interdisciplinary collaboration.

Responsibilities

• Provide physician oversight for medical necessity and level-of-care decisions with UM and Care Management.
• Perform concurrent review of high-risk or complex cases and support payer discussions.
• Advance timely progression of care by removing discharge barriers and promoting InterQual consistency.
• Collaborate with Revenue Cycle/Denials teams to reduce preventable denials via education and documentation feedback.
• Review adverse determinations and support appeal strategies with medical narratives.

Skills

Medical leadership

Documentation accuracy

InterQual expertise

Payer relations

Clinical communication

Education

MD or DO

Job description

Mosaic Life Care in Saint Joseph, MO, is seeking a Physician Advisor to lead medical necessity reviews, CDI initiatives, and collaboration with care management, HIM, and revenue cycle teams. The role emphasizes physician-to-physician communication, evidence-based practice, and regulatory compliance to optimize patient care and documentation accuracy.

The candidate will provide expert clinical review, peer-to-peer discussions, and education on documentation specificity, DIAGNOSIS linkage, and DRG