Regional Physician Advisor — Utilization & Quality Improvement

Sentara Healthcare Inc; Williamsburg, Northern (VA, KY); Hybrid; USD 180,000 - 240,000; Full time

Job summary

Sentara Health is seeking a Regional Physician Advisor to influence patient care, improve documentation and coding integrity, and drive compliant billing and denials management.

You will partner with hospital leaders and medical staff to advance utilization review, site-of-service decisions, and education across Sentara facilities. The role emphasizes on-site presence, collaboration, and strong communication to meet revenue cycle objectives.

Qualifications

• MD or DO from an accredited medical school.
• Completion of an accredited residency program.
• Minimum of 5 years of clinical hospital experience.
• Minimum of 2 years of physician advisory experience preferred.
• Active Virginia medical license
• Board certification in specialty at time of hire
• Strong understanding of CMS regulatory guidance for UR and site of service decisions
• Knowledge of clinical documentation integrity, hospital billing and coding processes

Responsibilities

• Support UR and Denials/Appeals processes to ensure compliant billing and appropriate level of care.
• Interface with hospital and medical staff leadership to align Revenue Cycle and hospital processes.
• Educate medical staff at Sentara facilities on documentation and coding practices.
• Support achievement of Clinical Revenue Cycle goals and operational excellence.

Skills

Clinical leadership

Regulatory knowledge

Documentation integrity

Communication

Team collaboration

EMR systems

Problem solving

Education

MD/DO

Tools

CMS guidelines

Job description

Sentara Health is seeking a Regional Physician Advisor to influence patient care, improve documentation and coding integrity, and drive compliant billing and denials management.

You will partner with hospital leaders and medical staff to advance utilization review, site-of-service decisions, and education across Sentara facilities. The role emphasizes on-site presence, collaboration, and strong communication to meet revenue cycle objectives.