Physician Advisor: Utilization & Quality Leader

AdventHealth; Orlando (FL); On-site; USD 207,000 - 413,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

PTO Day One

403-B Retirement Plan

Parental Leave 4 Weeks

Career Development

Well-being Resources

Mental Health Support

Pet Benefits

Job summary

AdventHealth in Orlando, FL is seeking a Physician Advisor to educate and advise Utilization Management, HIM, Revenue Cycle, Patient Access, and medical staff on utilization and denial prevention. The role provides physician‑level review of utilization, claims management, and quality assurance for inpatient, outpatient/observation, and referral services.

The Physician Advisor serves as a key clinical liaison for clinicians, payers, and regulators.

Qualifications

• 5+ years recent clinical practice experience.
• 2+ years or greater experience as a Physician Advisor.
• 3+ years of leadership experience.
• Medical Doctor (MD) or DO required.
• BLS preferred.

Responsibilities

• Reviews and authorizes inpatient days and utilization management.
• Collaborates with managed care payers and medical directors on denials and utilization criteria.
• Provides physician-level review of utilization, claims management, and quality assurance.
• Educates physicians and clinical teams on UM protocols and regulatory changes.
• Acts as clinical liaison with attending physicians and medical staff.
• Supports denial prevention strategies.
• Participates in Utilization Management and hospital committees.
• Supports organizational goals related to length of stay, quality, and resource stewardship.

Skills

Relationship building

Practicing physician

Detail-oriented

Analytical skills

Communication skills

Matrix management

Policy translation

Medical advisory

Microsoft Office

Education

Doctorate (MD/DO)

Master's in Business or Healthcare Administration

Tools

Microsoft Office Suite

Job description

AdventHealth in Orlando, FL is seeking a Physician Advisor to educate and advise Utilization Management, HIM, Revenue Cycle, Patient Access, and medical staff on utilization and denial prevention. The role provides physician‑level review of utilization, claims management, and quality assurance for inpatient, outpatient/observation, and referral services.

The Physician Advisor serves as a key clinical liaison for clinicians, payers, and regulators.