Physician Advisor: Utilization & Care Collaboration

Sentara Health; United States; On-site; USD 94,000 - 312,000; Full time

Benefits offered by this job

Medical plan

Dental plan

Vision plan

Paid Time Off

Parental leave

Disability insurance

Life Insurance

401k match

Tuition assistance

Student debt pay down

Pet insurance

Legal resources plan

Annual bonus eligibility

Job summary

Sentara Health seeks a Physician Advisor for Sentara Obici Hospital in Suffolk, VA. You will influence patient care, support physician engagement, and drive quality, compliance, and operational excellence while partnering with physicians and leaders across the system.

The on-site, full-time role requires hospital-based experience, strong CMS regulation knowledge, and the ability to educate clinicians on utilization review and hospital status determinations.

Qualifications

• MD/DO with accredited residency.
• Active Virginia medical license.
• Board certification in specialty.
• Minimum 3 years clinical experience.
• Knowledge of CMS regulations related to utilization review.

Responsibilities

• Perform timely and compliant medical necessity reviews with documentation.
• Facilitate denials management through peer-to-peer discussions and appeal letters.
• Collaborate with hospital leadership and medical staff to support system initiatives.
• Attend Hospital Utilization Management Committees and related meetings.
• Educate physicians and staff on utilization review, documentation integrity, and regulatory requirements.
• Complete required training and adapt to department needs.

Skills

Clinical expertise

Regulatory knowledge

CMS regulations

Communication skills

Collaborative leadership

Education

MD/DO

Residency trained

Virginia medical license

Board certification

Tools

EMR systems

InterQual

MCG

Peer-to-peer reviews

Job description

Sentara Health seeks a Physician Advisor for Sentara Obici Hospital in Suffolk, VA. You will influence patient care, support physician engagement, and drive quality, compliance, and operational excellence while partnering with physicians and leaders across the system.

The on-site, full-time role requires hospital-based experience, strong CMS regulation knowledge, and the ability to educate clinicians on utilization review and hospital status determinations.