Physician Utilization & Care Optimization Advisor

Mount Sinai Services/Elmhurst and Queens Hospital Center; New York (NY); On-site; USD 180,000 - 240,000; Full time

Job summary

Mount Sinai Services/Elmhurst and Queens Hospital Center seeks a full-time Physician Advisor to optimize health care resource use and ensure regulatory and payer compliance. The role involves acting as the physician liaison for utilization, working with case management, finance, and hospital leadership across areas of care progression, level of care, and denial management.

Requirements include an MD/DO, NY license, board certification, and willingness to practice clinically.

Qualifications

• MD/DO degree with NY license and board certification.
• DEA and Medicaid numbers required.
• Willingness to practice clinically in primary specialty.
• Strong foundation in utilization management and quality improvement.
• Familiarity with NYC Health + Hospitals case management operations and medical necessity criteria (MCG/InterQual).

Responsibilities

• Serve as the primary physician liaison for hospital utilization issues.
• Collaborate with case management and finance to optimize resource use and care quality.
• Develop and implement protocols, training, and initiatives for level of care and length of stay.
• Support denial management, documentation, and coding compliance.
• Engage with leadership and staff across departments to improve care and financial sustainability.

Skills

Utilization management

Quality improvement

Data analysis

Communication

Team collaboration

Documentation accuracy

Excel

Epic

Cisco WebEx

Education

MD/DO degree

Board-certified physician

New York State License

DEA & Medicaid numbers

Tools

Epic

Cisco WebEx

Job description

Mount Sinai Services/Elmhurst and Queens Hospital Center seeks a full-time Physician Advisor to optimize health care resource use and ensure regulatory and payer compliance. The role involves acting as the physician liaison for utilization, working with case management, finance, and hospital leadership across areas of care progression, level of care, and denial management.

Requirements include an MD/DO, NY license, board certification, and willingness to practice clinically.