Physician Advisor: Lead Utilization & Quality Improvement

Wellstar Health System; Griffin (GA); On-site; USD 180,000 - 260,000; Full time

Job summary

Wellstar Health System in Georgia is seeking a Physician Advisor to influence quality, utilization, and patient outcomes through performance improvement and education initiatives across facilities.

You will collaborate with CMOs, Care Coordination, and hospital leadership to review medical necessity, determine appropriate levels of care, and reduce readmissions, while guiding clinical documentation and payer relations.

Qualifications

• Doctorate in Medicine (DM) or Doctorate of Osteopathic Medicine (DO) - Required
• MD or DO license required
• Board certification in specialty - Preferred
• Health Care Quality & Management Certification - Preferred
• 8–10 years clinical experience - Required
• 1–3 years Utilization Management experience with focus on documentation, medical necessity, billing and coding - Required

Responsibilities

• Provide timely consultation to ensure fiscally responsible and efficient resource use across the facility.
• Lead or co-lead Hospital-wide Complex Care Rounds and performance improvement initiatives.
• Review medical necessity and appropriate level of care; give real time feedback to physicians and case managers.
• Collaborate with Care Coordination, Care Management, and hospital leadership to improve throughput, LOS, and readmission rates.
• Support education on payer utilization matters, evidence-based practices, and regulatory requirements.

Skills

English proficiency

Physician leadership

Time management

Budgeting

Analytical skills

Organizational skills

Education

Doctorate in Medicine

MBA (preferred)

Job description

Wellstar Health System in Georgia is seeking a Physician Advisor to influence quality, utilization, and patient outcomes through performance improvement and education initiatives across facilities.

You will collaborate with CMOs, Care Coordination, and hospital leadership to review medical necessity, determine appropriate levels of care, and reduce readmissions, while guiding clinical documentation and payer relations.