Physician Advisor — Utilization & Quality Strategy

AdventHealth; Orlando (FL); On-site; USD 209,000 - 417,000; Full time

Benefits offered by this job

Benefits from Day One: Medical, Dental

Paid Time Off from Day One

403-B Retirement Plan

4 Weeks Paid Parental Leave

Career Development

Whole Person Well-being Resources

Mental Health Resources and Support

Pet Benefits

Job summary

AdventHealth is seeking a Physician Advisor to educate and advise Utilization Management, HIM, Revenue Cycle, Patient Access, Managed Care teams, and medical staff on updates and trends related to utilization and denial prevention.

This physician will provide reviews of inpatient and outpatient care, support decision‑making with clinicians, payers, and regulators, and promote high‑quality, cost‑effective care.

Qualifications

• Doctorate in medicine required (MD/DO).
• Minimum 5+ years of recent clinical practice.
• 2+ years of physician advisor experience preferred.
• 3+ years of leadership experience preferred.
• Excellent communication and collaboration across multi-disciplinary teams.

Responsibilities

• Reviews inpatient/outpatient determinations and utilization patterns.
• Acts as clinical liaison with attending physicians and medical staff.
• Collaborates with managed care payers on denials, appeals, and utilization criteria.
• Provides education to physicians and clinical teams on UM protocols and regulatory changes.
• Supports denial prevention strategies and quality initiatives.
• Participates in Utilization Management and hospital committees.

Skills

Relationship building

Analytical skills

Communication skills

Matrix management

Microsoft Office

Clinical practice

Leadership experience

Education

Doctorate (MD/DO)

Master's degree (preferred)

Tools

Microsoft Office Suite

Job description

AdventHealth is seeking a Physician Advisor to educate and advise Utilization Management, HIM, Revenue Cycle, Patient Access, Managed Care teams, and medical staff on updates and trends related to utilization and denial prevention.

This physician will provide reviews of inpatient and outpatient care, support decision‑making with clinicians, payers, and regulators, and promote high‑quality, cost‑effective care.