Physician Advisor Director: Utilization & Quality

Boston Medical Center; Baltimore (MD); On-site; USD 148,000 - 267,000; Full time

Job summary

GBMC HealthCare in Towson, MD seeks a Physician Advisor Director to lead a multidisciplinary team involved in case management, coding, UR, and population health. The role focuses on level of care decisions, denial management, and ensuring quality of care aligned with current standards.

The director provides strategic direction, develops policies, and coordinates with executive leadership to improve efficiency and patient outcomes while supporting compliance and accreditation efforts.

Qualifications

• MD or DO from an accredited medical program.
• State of Maryland medical license and board certification in Internal Medicine.
• 2–4 years in Utilization Management and 5 years clinical experience.
• Familiarity with Pay for Performance/VBP initiatives.

Responsibilities

• Provide leadership to physician advisory team including Associate Physician Advisors, UR, Case Management and Social Work.
• Oversee level of care reviews, denial reviews and appeals management for all hospital patients.
• Develop and oversee policies and procedures for Physician Advisor services.
• Ensure compliance with regulatory requirements and accreditation processes.
• Collaborate with hospital leadership to optimize utilization management and patient care.

Skills

Interpersonal skills

Utilization review

Clinical quality management

Education and quality improvement

Regulatory knowledge

Education

Medical degree

Job description

GBMC HealthCare in Towson, MD seeks a Physician Advisor Director to lead a multidisciplinary team involved in case management, coding, UR, and population health. The role focuses on level of care decisions, denial management, and ensuring quality of care aligned with current standards.

The director provides strategic direction, develops policies, and coordinates with executive leadership to improve efficiency and patient outcomes while supporting compliance and accreditation efforts.