Care Management & Utilization Management Physician Advisor
Updated 10/01/26
$250,000
– $500,000
yearly
41 East Post Road, White Plains, New York, 10601, United States
Physician
Internal Medicine
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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
White Plains Hospital is seeking a Care Management & Utilization Management Physician Advisor to provide physician leadership across clinical operations, Care Management, Utilization Management, Clinical Documentation Integrity, Quality, Patient Safety, and Revenue Cycle. This role partners with physicians and interdisciplinary teams to promote high-quality, efficient, patient-centered care while supporting accurate clinical documentation, appropriate utilization, care progression, regulatory compliance, and improved clinical outcomes. The Physician Advisor will serve as a trusted physician resource for complex cases, medical necessity, payer issues, documentation and coding questions, performance improvement, and physician engagement.
Job Responsibilities
* Support appropriate admission, patient status, level of care, medical necessity, and care progression decisions.
* Participate in payer peer-to-peer reviews, denials, appeals, and complex case escalations.
* Partner with CDI and Coding to promote accurate, complete, and clinically supported documentation and coding.
* Identify opportunities to improve quality, patient safety, length of stay, care coordination, readmissions, and high-value care.
* Collaborate with multidisciplinary teams to address barriers to discharge and transitions of care.
* Use clinical and operational data to identify performance improvement opportunities and measure results.
* Educate and engage physicians regarding documentation, utilization, regulatory requirements, and evidence-based practice.
* Lead or participate in hospital-wide performance improvement, physician engagement, and strategic initiatives.
Qualifications
* Current, unrestricted medical license in the state of New York.
* Board certification in a medical specialty.
* Minimum of 10 years of clinical practice and progressive physician leadership experience.
* Experience in Physician Advisor work, Care Management, Utilization Management, CDI, Coding, Quality, Patient Safety, hospital operations, or related clinical leadership preferred.
* Experience leading multidisciplinary performance improvement or change-management initiatives preferred.
* Strong communication, collaboration, problem-solving, and physician engagement skills.
* Ability to work effectively across clinical, operational, and administrative teams.
* CMPC, ACPA-C, CPE, or similar physician leadership certification is a plus.
Working Hours
Skills
* Care Management and Utilization Management
* Medical necessity and payer relations
* Clinical Documentation Integrity and coding
* Quality and patient safety
* Performance improvement and change management
* Care progression and transitions of care
* Data analysis and performance management
* Physician engagement and education
* Strong communication, facilitation, negotiation, and conflict-resolution skills
* High-value care and resource stewardship
* Regulatory and compliance knowledge
By applying you agree to our Terms of Service