Physician Advisor (Remote)

Virginia Jobs$250K — $350K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • MD or DO
  • Board Certified in Family Medicine, Internal Medicine or Pediatrics
  • Eligible for Virginia medical licensure
  • Prior Utilization Management experience preferred
  • Knowledge of CMS regulations and MCG/InterQual guidelines
  • Excellent communication and collaboration skills

Responsibilities

  • Perform medical necessity reviews using MCG and/or InterQual
  • Support CMS compliance, including the 2-Midnight Rule and inpatient status determinations
  • Partner with Case Management, CDI, and physician teams to improve documentation and patient flow
  • Provide physician education, documentation feedback, and CDI query support
  • Conduct peer-to-peer reviews and assist with denial prevention and appeals
  • Participate in quality, compliance, and operational improvement initiatives

Benefits

  • Fully remote position with occasional on-site meetings
  • Collaborative environment with multidisciplinary teams
  • Opportunity to shape system-wide initiatives
  • Focus on quality improvement and operational outcomes
Full Job Description
Job Description

Physician Advisor (Remote)

Opportunity

UVA Health is seeking an experienced Physician Advisor to provide physician leadership across Utilization Management (UM), Clinical Documentation Integrity (CDI), Coding, and Case Management. This remote role focuses on medical necessity, regulatory compliance, documentation improvement, and advancing quality and operational outcomes. Join a dedicated and collaborative team that is valued by health system leadership for this unique skillset.

Key Responsibilities
  • Perform medical necessity reviews using MCG and/or InterQual
  • Support CMS compliance, including the 2-Midnight Rule and inpatient status determinations
  • Partner with Case Management, CDI, and physician teams to improve documentation and patient flow
  • Provide physician education, documentation feedback, and CDI query support
  • Conduct peer-to-peer reviews and assist with denial prevention and appeals
  • Participate in quality, compliance, and operational improvement initiatives

Position Highlights
  • Fully remote physician leadership opportunity (with the exception of 4 on-site meetings per year that are 1-day meetings)
  • Collaborate with multidisciplinary teams across UVA Health
  • Improve clinical documentation, utilization practices, and patient outcomes
  • Help shape system-wide initiatives in quality, compliance, and stewardship

Qualifications
  • MD or DO
  • Board Certified in Family Medicine, Internal Medicine or Pediatrics
  • Eligible for Virginia medical licensure
  • Prior Utilization Management experience preferred
  • Knowledge of CMS regulations and MCG/InterQual guidelines
  • Excellent communication and collaboration skills


The base compensation range for this role is $250,000 - $350,000 for a 1.0 clinical FTE status.

Individual compensation will be determined by fair market value and the selected candidate's qualifications, clinical experience, specialty training, credentials, and/or education. Please note that the pay range does not include any applicable incentive compensation programs, such as productivity, quality, non-productivity, or other incentives that may be available for eligible positions.

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