Physician Advisor: Utilization & CDI Leader

01 Kaweah Delta Health Care District; Visalia (CA); On-site; USD 193,000 - 289,000; Full time

Benefits offered by this job

Benefits Eligible

Job summary

Kaweah Health in Visalia, CA, seeks a Physician Advisor to serve as a clinical liaison among medical staff, case management, and hospital administration. The role ensures appropriate resource utilization, supports accurate documentation, and promotes regulatory compliance while guiding medical necessity decisions.

The position emphasizes leadership, collaboration with utilization review teams, and continuous improvement in inpatient documentation and case management processes.

Qualifications

• Current MD/DO license in good standing.
• Experience in utilization review, case management, or physician advisory services.
• Strong knowledge of CMS regulations, payer guidelines, and clinical documentation standards.

Responsibilities

• Serve as the physician champion for UM and CDI, driving provider alignment and accountability.
• Influence practices through peer-to-peer leadership and clinical credibility.
• Provide real-time physician-to-physician consultation regarding admissions, utilization management, and documentation.
• Collaborate with case management and utilization review teams to optimize patient flow and resource use.
• Review patient cases for medical necessity, appropriate level of care, and length of stay.
• Monitor LOS outliers; work with care teams to improve throughput and avoid delays.
• Ensure inpatient documentation reflects severity, mortality risk, and medical decision-making.
• Improve capture of diagnoses and comorbidities for DRGs and outcomes.

Skills

Communication

Analytical skills

Leadership

Education

MD/DO license

ABQAURP CPA

Job description

Kaweah Health in Visalia, CA, seeks a Physician Advisor to serve as a clinical liaison among medical staff, case management, and hospital administration. The role ensures appropriate resource utilization, supports accurate documentation, and promotes regulatory compliance while guiding medical necessity decisions.

The position emphasizes leadership, collaboration with utilization review teams, and continuous improvement in inpatient documentation and case management processes.