Physician Advisor

• Provide strategic input into utilization management planning, resource allocation, and broader healthcare initiatives.
• Partner with medical staff leadership, physicians, case managers, utilization management teams, social services, and discharge planning teams to optimize hospital resource use.
• Develop and support utilization management protocols designed to improve length of stay, appropriate level of care, documentation, and use of diagnostic and therapeutic services.
• Conduct physician and clinician education sessions covering utilization trends, practice patterns, regulatory requirements, appropriate admissions, community resources, and alternative levels of care.
• Investigate avoidable delays and utilization concerns that may affect patient outcomes or hospital efficiency.
• Monitor developments in medical practice models, regulatory requirements, licensure standards, and third-party payer policies.
• Identify denial trends and collaborate with physicians and hospital administration to address underlying issues and improve outcomes.
• Analyze practice patterns, resource utilization, and performance data to identify trends, opportunities, and areas for improvement.
• Present utilization and practice-pattern findings to service lines, departments, committees, and hospital leadership as requested.
• Support the development and implementation of new patient care programs and evaluate potential hospital and medical staff initiatives.
• Represent utilization management on assigned hospital committees and serve as a consulting representative across system hospitals.
• Help resolve utilization management-related conflicts in collaboration with medical staff leadership.
• Support compliance with medical staff bylaws, rules, regulations, policies, and procedures related to utilization management.
• Contribute to information technology and reporting initiatives that provide physicians with meaningful feedback on performance and resource utilization.
• Support regulatory compliance, licensure requirements, quality improvement objectives, and applicable federal and state healthcare standards.
• Complete the contracted administrative hours and provide required quarterly documentation of time and activities.
• Maintain clinical responsibilities as determined by the physician's home clinical department.

Requirements:

• Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree from an accredited medical school.
• Board certification through a specialty board recognized by the American Board of Medical Specialties.
• Current or eligible medical licensure in the State of West Virginia.
• A minimum of five years of clinical experience in the practice of medicine is preferred.
• Strong understanding of utilization management, clinical operations, patient flow, resource utilization, and healthcare quality principles.
• Ability to interpret and apply regulatory requirements, medical staff policies, licensure standards, and third-party payer guidelines.
• Strong analytical skills, with the ability to evaluate clinical and operational data, recognize trends, and translate findings into actionable improvements.
• Excellent communication and physician-engagement skills, with the ability to educate clinicians and collaborate effectively with multidisciplinary stakeholders.
• Sound judgment and problem-solving abilities when addressing utilization concerns, avoidable delays, documentation issues, denials, and competing operational priorities.
• Ability to work collaboratively with medical staff leadership, hospital administration, clinical teams, and external regulatory or payer stakeholders.
• Willingness and ability to travel between system hospitals when required.
• Ability to operate effectively in a complex, multi-hospital healthcare environment while balancing clinical, administrative, regulatory, and financial considerations.

Benefits:

• Full-time, 40-hour-per-week position.
• Exempt employment status.
• Opportunity to influence utilization management, quality improvement, and patient care across a broad healthcare network.
• Collaborative environment involving physicians, hospital leaders, case management, utilization management, and multidisciplinary clinical teams.
• Meaningful opportunity to improve patient outcomes while supporting efficient and financially responsible healthcare delivery.
• Exposure to strategic planning, clinical program development, regulatory initiatives, and system-wide performance improvement.
• Professional environment combining clinical practice with physician leadership and healthcare operations.
• Opportunities to contribute to physician education, data-driven decision-making, and organizational quality initiatives.
• Travel opportunities across multiple affiliated hospital locations as part of system-wide consulting responsibilities.