Physician Advisor - Clinical Documentation & Utilization

St. Mary's Health Care System; Athens (GA); On-site; USD 180,000 - 240,000; Full time

Job summary

St. Mary’s Health Care System in Georgia seeks a Physician Advisor to lead clinical documentation improvement, optimize case mix, and ensure medical necessity compliance across the hospital.

This 1099 role collaborates with CDI, quality, and revenue cycle teams to improve patient status determinations and resource utilization. You will provide peer-to-peer education, participate in daily rounds, and drive initiatives to shorten stay, reduce denials, and enhance throughput while maintaining high

Qualifications

• MD or DO degree from an accredited institution.
• Board certification in a recognized medical specialty.
• Active, unrestricted medical license to practice in Georgia.
• Minimum 5 years of clinical practice experience.
• Experience in hospital-based care.
• Demonstrated leadership and team-building skills.

Responsibilities

• Improve clinical documentation accuracy and completeness with CDI partners.
• Provide physician education on documentation requirements (Severity of illness, ROM, CC/MCC, DRG).
• Assist with case mix index (CMI) improvement initiatives.
• Guide medical necessity determinations and inpatient vs. observation status reviews.
• Lead efforts to reduce unnecessary length of stay and delays in discharge.
• Engage physicians and staff through education and presentations at meetings and committees.
• Identify and address denials contributing to medical necessity issues and support appeals.
• Support quality, compliance, and utilization review activities to align with regulations.

Skills

Clinical leadership

Collaboration

Communication skills

Stakeholder engagement

Regulatory compliance

Education

MD or DO degree

Board Certification in a medical specialty

Job description

St. Mary’s Health Care System in Georgia seeks a Physician Advisor to lead clinical documentation improvement, optimize case mix, and ensure medical necessity compliance across the hospital.

This 1099 role collaborates with CDI, quality, and revenue cycle teams to improve patient status determinations and resource utilization. You will provide peer-to-peer education, participate in daily rounds, and drive initiatives to shorten stay, reduce denials, and enhance throughput while maintaining high