Physician Utilization & Care Optimization Advisor

Covenant HealthCare; Saginaw (MI); On-site; USD 180,000 - 240,000; Full time

Job summary

Covenant HealthCare in Michigan is seeking a Physician Advisor to act as a liaison between physicians, Clinical Resource Management, and hospital leadership. You will advise on best practices for throughput and appropriate levels of care while staying current with changing regulations.

The role emphasizes peer-to-peer discussions, education on regulatory requirements, and collaboration with case management to optimize length of stay and patient outcomes across inpatient units.

Qualifications

• Must be a practicing physician with hospital-based experience.
• Proficient in EMR documentation and clinical workflows.
• Up-to-date knowledge of regulatory requirements and medical necessity.

Responsibilities

• Communicates with physicians about resource utilization and throughput.
• Facilitates input on medical necessity and denial cases.
• Provides guidance on levels of care and length of stay.
• Reviews cases for medical necessity and appropriate care levels.
• Educates physicians on regulatory requirements and evidence-based care.
• Participates in daily multidisciplinary rounds and case reviews.
• Engages with payers and Medical Directors to resolve denials.
• Works with case management to optimize patient flow and outcomes.

Skills

Interpersonal skills

EMR proficiency

Regulatory knowledge

Utilization management

Peer-to-peer communication

Stakeholder collaboration

Education

Medical degree

Michigan medical license

Tools

EMR systems

Job description

Covenant HealthCare in Michigan is seeking a Physician Advisor to act as a liaison between physicians, Clinical Resource Management, and hospital leadership. You will advise on best practices for throughput and appropriate levels of care while staying current with changing regulations.

The role emphasizes peer-to-peer discussions, education on regulatory requirements, and collaboration with case management to optimize length of stay and patient outcomes across inpatient units.