Senior Physician Advisor: Utilization & Quality Improvement

Wellstar Health System; Griffin (GA); On-site; USD 180,000 - 240,000; Full time

Job summary

Wellstar Health System is seeking a Physician Advisor to influence quality, utilization, patient satisfaction and efficiency through performance improvement and education initiatives. You will collaborate with VPMA and hospital leaders to guide care pathways, review medical necessity, and lead readmission reduction efforts.

The role involves real-time consultation with physicians, case management staff, and hospital administration to optimize resource use and patient outcomes.

Qualifications

• Doctorate in Medicine (MD) or Doctorate in Osteopathic Medicine (DO).
• MBA/Health Administration preferred or similar.
• Board certification in specialty; licensure upon hire.
• Minimum 8 years clinical experience; 1–3 years Utilization Management post residency.

Responsibilities

• Lead utilization management reviews to assess medical necessity and appropriate level of care.
• Collaborate with VPMA and Quality Department to meet annual hospital goals.
• Co-lead Hospital-wide Complex Care Rounds and improve patient throughput.
• Respond to payers, denials, and appeals and assist in care transition decisions.
• Ensure accurate clinical documentation to support medical necessity and levels of care.

Skills

Verbal & written English

Leadership

Time management

Organizational skills

Analytical skills

Budget & financial planning

Education

MD or DO

MBA/Health Administration preferred

Job description

Wellstar Health System is seeking a Physician Advisor to influence quality, utilization, patient satisfaction and efficiency through performance improvement and education initiatives. You will collaborate with VPMA and hospital leaders to guide care pathways, review medical necessity, and lead readmission reduction efforts.

The role involves real-time consultation with physicians, case management staff, and hospital administration to optimize resource use and patient outcomes.