Physician Advisor - FT

Tenet Healthcare Corporation

Worcester (MA)

On-site

USD 180,000 - 240,000

Full time

3 days ago
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Job summary

Tenet Healthcare Corporation is seeking a Physician Advisor to serve as a physician leader and strategic partner with hospital administration, medical staff, case management, CDI, HIM, and revenue cycle teams. The role focuses on enabling medically necessary, high-quality, and efficient patient care while advancing throughput, length of stay, documentation integrity, and regulatory compliance.

The advisor collaborates with physicians and executive leadership to improve clinical, operational,

Qualifications

  • Education: Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.).
  • Experience: Active or recent hospital-based clinical practice experience.
  • Certifications: Active unrestricted medical license and ABMS-board certification.

Responsibilities

  • Perform secondary physician Reviews and medical necessity determinations.
  • Conduct peer-to-peer discussions with payer medical directors.
  • Support denial prevention, appeal, and overturn activities.
  • Collaborate with case management, utilization management, CDI, and HIM teams.
  • Provide physician leadership and education to improve documentation quality and compliance.
  • Serve as liaison between medical staff and hospital leadership.

Education

Doctor of Medicine Degree (M.D.)
Doctor of Osteopathic Medicine Degree (D.O.)

Job description

Job Summary

The Physician Advisor serves as a physician leader and strategic partner to hospital administration, medical staff, case management, utilization management, clinical documentation integrity (CDI), health information management (HIM), and revenue cycle teams. This non-clinical leadership role supports the delivery of medically necessary, high-quality, and efficient patient care while advancing organizational goals related to patient throughput, length of stay, documentation integrity, denial prevention, regulatory compliance, and physician engagement.

The Physician Advisor collaborates closely with physicians, nursing leadership, case management, CDI, HIM, and executive leadership to improve clinical, operational, quality, and financial outcomes across the organization.

Responsibilities

Perform secondary physician reviews and medical necessity determinations. Conduct peer-to-peer discussions with payer medical directors. Support denial prevention, appeal, and overturn activities. Collaborate with case management and utilization management teams regarding level-of-care determinations. Provide physician leadership and support for utilization management initiatives and committees. Participate in multidisciplinary rounds, eTEMPO, and patient throughput activities. Support observation management and length-of-stay optimization initiatives. Partner with CDI and HIM teams to improve documentation quality, accuracy, and compliance. Conduct one-on-one physician education and coaching based on identifying outlier performance through our data platforms. Serve as a liaison between medical staff and hospital leadership.

Qualifications

Education:

Required: Doctor of Medicine Degree (M.D.) or Doctor of Osteopathic Medicine Degree (D.O.).

Experience:

Required: Active or recent hospital-based clinical practice experience.
Preferred: Prior Physician Advisor experience. Utilization Management experience. CDI or Case Management experience. Medical Staff leadership experience. Experience with MCG and/or InterQual criteria. Familiarity with Medicare Advantage, Medicaid, and Commercial payer processes.

Certifications:

Required: Active unrestricted medical license. Board certification by an ABMS-recognized specialty board.

Physical Demands:

Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Tenet participates in the E-Verify program. Follow the link below for additional information.
E-Verify: http://www.uscis.gov/e-verify
The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations.

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