Physician Advisor: Utilization & Care Optimization

NEJM; Detroit (MI); On-site; USD 180,000 - 240,000; Full time

Job summary

Henry Ford Health is seeking a Physician Advisor to partner with medical leadership, hospital staff, and revenue cycle teams to optimize utilization and ensure high-quality patient care across the system.

You will lead medical necessity reviews, mentor clinicians on documentation, coordinate with MCG/InterQual criteria, and support regulatory audits while advancing patient outcomes and cost-effective care. Must hold an unrestricted Michigan medical license and have 5+ years of clinical practice.

Qualifications

• MD or DO medical degree with current licensure.
• Minimum five years of clinical practice.
• Board Certification in a relevant specialty preferred.
• Solid understanding of utilization management and regulatory requirements.
• Familiarity with MCG/InterQual criteria preferred.

Responsibilities

• Review medical records for quality and utilization oversight.
• Conduct medical necessity reviews including levels of care and continued stay.
• Participate in Peer-to-Peer discussions for denials and post-acute care.
• Educate physicians and clinicians on regulatory requirements and care standards.
• Assist with documentation improvement and coding accuracy.
• Coordinate with Revenue Cycle and hospital leadership on utilization issues.

Skills

Utilization management

Regulatory compliance

Physician education

Communication with physicians

Quality improvement

Education

MD/DO

Unrestricted Michigan medical license

Tools

EPIC

Job description

Henry Ford Health is seeking a Physician Advisor to partner with medical leadership, hospital staff, and revenue cycle teams to optimize utilization and ensure high-quality patient care across the system.

You will lead medical necessity reviews, mentor clinicians on documentation, coordinate with MCG/InterQual criteria, and support regulatory audits while advancing patient outcomes and cost-effective care. Must hold an unrestricted Michigan medical license and have 5+ years of clinical practice.