Physician Advisor
Updated 3/18/26
$91.00
– $127.00
hourly
Wayne, New Jersey, United States
Physician
Internal Medicine
By applying you agree to our Terms of Service
Job at a glance
Degree Required
MD/DO
Position Type
Full-Time
Work Environment
Hospital
Visa Sponsorship
No
Experience Level
5 years
Job description
Job description
The Physician Advisor (PA) is a clinical leader responsible for ensuring appropriate patient care, optimizing resource utilization, and maintaining regulatory compliance. The PA conducts medical necessity and utilization reviews, manages denials and appeals, advises providers on patient status and documentation, and collaborates with Care Management and hospital leadership to improve throughput, length of stay, and overall quality outcomes.
Job Responsibilities
Apply the Two-Midnight Rule, payer guidelines, and manage denials and appeals.
Educate providers on documentation, patient status, and utilization management processes.
Participate in utilization management committees and escalate non-compliance trends.
Collaborate with leadership and care teams to optimize patient flow, length of stay, and quality outcomes.
Recommend evidence-based care coordination steps and support quality improvement initiatives.
Maintain compliance with CMS and regulatory standards.
Present to medical staff or administration and perform additional duties as assigned.
Qualifications
Ongoing education in quality improvement and utilization management (CME/self-study)
Minimum 5 years recent clinical practice experience
Active, unrestricted New Jersey physician license
Prior Utilization Management Committee or Physician Advisor experience preferred
Preferred Qualifications & Competencies:
Strong clinical judgment and medical necessity expertise
Knowledge of care management, utilization review, and third-party payer requirements
Experience with denials management and clinical documentation standards
Familiarity with CMS, Joint Commission, and New Jersey Department of Health regulations
Teaching, coaching, and presentation skills
Analytical, problem-solving, and process improvement abilities
Collaborative leadership with clinical credibility among physicians
Persuasive communication, strong follow-through, and accountability
Working Hours
By applying you agree to our Terms of Service