Physician Advisor - MedStar Multisite

ACPM; United States; Hybrid; USD 250,000 - 350,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid malpractice insurance

Paid Time Off

Retirement plan

Job summary

MedStar Health seeks a Physician Advisor to join a hybrid role supporting hospitals across the system. The physician will optimize resource use, reduce length of stay, and prevent clinical denials, working with case management and hospital leaders to ensure timely, appropriate care.

Qualifications include MD/DO with board certification and 5+ years clinical experience; familiarity with MCG and InterQual criteria is preferred. Salary range USD 250,000–350,000 per year plus comprehensive benefits.

Qualifications

• MD or DO with board certification required.
• ACPA-C or ABQUARP certification preferred or willingness to obtain within 1 year.

Responsibilities

• Review patient status, medical necessity, and level of care.
• Lead clinical denial interventions and denial root cause determinations.
• Engage in concurrent and retrospective denials management and payer discussions.
• Drive length of stay improvements with case management and hospital stakeholders.
• Educate physicians on regulatory requirements and appropriate utilization of hospital services.

Skills

Clinical practice

Denials management

Utilization review

Regulatory knowledge

Education

MD/DO; Board Certified

ACPA-C or ABQUARP preferred

Tools

MCG criteria

InterQual criteria

Job description

Physician Advisor - MedStar Multisite

MedStar Health is seeking a Physician Advisor to join our team in a hybrid role supporting hospitals across the MedStar Health System. The Physician Advisor is an essential part of the team, using medical expertise to optimize resource use, reduce length of stay, and prevent clinical denials. Their work ensures patients receive appropriate, timely care.

In this role, you'll:

• Review patient status, medical necessity, and level of care
• Lead clinical denial interventions, denial root cause determinations and upstream process improvement initiatives
• Engage in concurrent and retrospective denials management and peer to peer discussions with payers
• Drive length of stay improvements in close collaboration with case management and hospital stakeholders
• Provide education to physicians and other clinicians related to regulatory requirements, appropriate utilization of hospital services, community resources, and alternative level of care
• Participate in Interdisciplinary Rounds (IDR) with the Healthcare Team as indicated
• Ensure regulatory compliance of Utilization Management and Discharge planning processes

At MedStar Health, you can expect:

• A competitive salary
• Medical, dental, and vision insurance
• Paid malpractice insurance
• Paid Time Off
• Retirement plan

Education/Training:

• Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) - Board Certification required (Internal Medicine or Emergency Medicine preferred)
• Preferred: Additional certification in healthcare administration, business, or physician advisory

Experience:

• Minimum 5 years of direct clinical practice required, hospital based experience preferred
• Previous experience as physician advisor preferred
• Strong knowledge of case management, utilization review, regulatory standards, denials management, observation medicine, and length of stay
• Familiarity with MCG and InterQual clinical criteria

Licensure/Certification:

• Current medical license in the practicing state
• Board Certified
• Preferred: ACPA-C or ABQUARP certification in Physician Advisory (or willingness to obtain within 1 year of hire) #LI-SS1

#PL

This position has a hiring range of

USD $250,000.00 - USD $350,000.00 /Yr.

In addition to your salary, MedStar Health offers a comprehensive healthcare package (including medical, dental and vision subject to eligibility requirements) and other benefits. The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by MedStar Health. MedStar Health is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The hiring range is the range MedStar Health, in good faith, believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on work experience, education and/or skill level, etc. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in MedStar Health's sole discretion unless and until paid and may be modified at MedStar Health's sole discretion, consistent with the law.

Why MedStar Health?

• Strong emphasis on teamwork-our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
• Strategic focus on equity, inclusion, & diversity-we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
• Comprehensive total rewards package-including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
• More career opportunities closer to home-as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.

About MedStar Health

MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C. region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people.

MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health entities that are federal government contractors are Equal Opportunity and Affiantative Action employers. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.