Senior Physician Advisor, Utilization & Quality Improvement

3710 Paulding Medical Center, Inc.; United States; On-site; USD 180,000 - 280,000; Full time

Job summary

Wellstar Health System seeks a Physician Advisor to drive quality, utilization, and efficiency through performance improvement and education initiatives. The role collaborates with CMOs across WHS to review medical necessity, manage care levels, and lead readmission reduction efforts.

Required is an MD/DO with board certification and 8–10 years in utilization management, plus strong communication and leadership skills for hospital-wide initiatives.

Qualifications

• Doctorate of Medicine or Osteopathic Medicine and licensed to practice.
• MBA or health administration degree preferred.
• 8–10 years clinical experience with utilization management.

Responsibilities

• Provide clinical consultation to ensure appropriate level of care.
• Lead readmission reduction initiatives with senior leadership.
• Assist with denial management and concurrent reviews.
• Collaborate with Care Coordination to improve throughput.
• Review documentation for medical necessity and accuracy.
• Lead hospital-wide complex care rounds and improve outcomes.

Skills

Clinical leadership

Healthcare quality

Communication

Medical necessity assessment

Education & training

Staff collaboration

Education

MD/DO

MBA in Healthcare Management

Board certified in specialty

Tools

Care Management Software

Electronic Health Records (EHR)

Job description

Wellstar Health System seeks a Physician Advisor to drive quality, utilization, and efficiency through performance improvement and education initiatives. The role collaborates with CMOs across WHS to review medical necessity, manage care levels, and lead readmission reduction efforts.

Required is an MD/DO with board certification and 8–10 years in utilization management, plus strong communication and leadership skills for hospital-wide initiatives.