Physician Advisor - Utilization & Clinical Excellence

Physician Affiliate Group of New York; New York (NY); On-site; USD 241,000 - 246,000; Full time

Benefits offered by this job

CME reimbursement

PTO: Vacation, Sick, Holiday, CME days

Medical, Prescription, Dental coverage

Life Insurance and AD&D 2x salary

Loan forgiveness programs

Visa sponsorship may be considered

Job summary

Physician Affiliate Group of New York (PAGNY) is adding a Physician Advisor to NYC Health + Hospitals/Kings County in Brooklyn, NY. The role focuses on clinical utilization, denial prevention, and documentation alignment with ICD-10 and medical necessity criteria.

Compensation includes base salary of $241,000–$246,000 with a total compensation package estimated around $320k–$326k, plus CME reimbursement, PTO, comprehensive benefits, and potential loan forgiveness.

Qualifications

• Board eligible or board certified in Internal Medicine.
• Licensed to practice in the State of New York.
• 1–2 years of Physician Advisor experience.

Responsibilities

• Identify denial trends and perform root cause analysis.
• Collaborate with ED to reduce avoidable admissions and improve documentation at entry.
• Familiarize physicians and case managers with MCG and InterQual criteria.
• Participate in performance improvement projects within Kings County and system-wide.
• Review records to support utilization management and align with payer guidelines.
• Work with clinicians, nurses, case managers, and admins to align utilization and care workflows.

Education

Board eligible for Internal Medicine certification

Job description

Physician Affiliate Group of New York (PAGNY) is adding a Physician Advisor to NYC Health + Hospitals/Kings County in Brooklyn, NY. The role focuses on clinical utilization, denial prevention, and documentation alignment with ICD-10 and medical necessity criteria.

Compensation includes base salary of $241,000–$246,000 with a total compensation package estimated around $320k–$326k, plus CME reimbursement, PTO, comprehensive benefits, and potential loan forgiveness.