Physician Advisor – Utilization & Care Optimization

New York City Health and Hospitals Corporation; New York (NY); On-site; USD 201,000 - 336,000; Full time

Job summary

Mount Sinai Health System is seeking a full-time Physician Advisor to support hospital utilization goals, ensuring efficient use of healthcare resources. The role acts as the physician liaison on medical necessity, levels of care, length of stay, and denial management across the system.

The candidate must hold an MD/DO, be Board-Certified, possess a NYS license, and have DEA/Medicaid numbers. At least five years of medical practice is required, with strong skills in utilization management,

Qualifications

• MD or DO degree; Board-Certified; NYS license, DEA and Medicaid numbers.
• Willing to work clinically in primary specialty.
• Minimum five years medical practice experience.
• Familiarity with MCG and InterQual criteria; strong computer skills incl. Excel, Epic, Cisco WebEx.

Responsibilities

• Collaborate with case management and finance to optimize use of resources.
• Develop and implement protocols to improve level of care, length of stay, and denial management.

Skills

Utilization management

Quality improvement

Clinical practice

Education

MD or DO

Board-Certified

New York State License

DEA and Medicaid numbers

Tools

Microsoft Excel

Epic

Cisco WebEx

Job description

Mount Sinai Health System is seeking a full-time Physician Advisor to support hospital utilization goals, ensuring efficient use of healthcare resources. The role acts as the physician liaison on medical necessity, levels of care, length of stay, and denial management across the system.

The candidate must hold an MD/DO, be Board-Certified, possess a NYS license, and have DEA/Medicaid numbers. At least five years of medical practice is required, with strong skills in utilization management,