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Physician Advisor (Administrative Role)- Hybrid Remote

MASC Medical • Remote (Delray Beach, FL, United States) • 8h ago

Job Description
Job Title: Physician Advisor
Location: Boynton Beach, FL - Hybrid Remote
Relocation Assistance: Available
Position Summary:
We are seeking a Physician Advisor (PA) to serve as a key clinical liaison between the medical staff, case management, and hospital leadership. This role is focused on optimizing hospital utilization, ensuring compliance with federal and state regulations, and improving clinical outcomes.
The Physician Advisor works collaboratively with case managers, social workers, and admitting physicians to ensure patients are placed at the correct level of care and that medical necessity is well-documented. The PA also addresses issues around clinical documentation, billing compliance (including CMS 2-Midnight Rule), length of stay, readmissions, and quality metrics. This position reports through a matrix structure to the Corporate Physician Advisor, Chief Quality and Integration Officer (CQIO), and entity-level CMO/CEO.
Key Responsibilities:

Provide real-time clinical guidance to ensure appropriate level of care and utilization
Support accurate clinical documentation to reflect severity of illness and medical necessity
Collaborate with providers and hospital staff to improve care transitions and reduce LOS/readmissions
Conduct post-discharge audits and respond to payer reviews or appeals
Educate medical staff on CMS regulations, InterQual/MCG criteria, and billing requirements
Drive clinical practice improvements that enhance patient care and hospital performance
Promote interdepartmental collaboration and communication through education and support
Maintain knowledge of current compliance standards and payer guidelines through ongoing education

Qualifications:

MD or DO degree from an accredited institution
Active medical license in Florida
Minimum 3 years of clinical practice experience
Experience with medical necessity reviews and use of MCG or InterQual criteria
Knowledge of CMS Conditions of Participation, billing regulations, and the 2-Midnight Rule
Strong communication, organization, and critical thinking skills

Certifications:

Board Certification by ABQAURP (or equivalent) required within 1 year of hire
Physician Advisor Certification preferred at time of hire

Additional Skills:

Ability to manage multiple deadlines and shifting priorities
Proficiency in relevant technology and EMR systems
Ability to lead and educate in both individual and group settings
Demonstrated professionalism and sound clinical judgment

#MASC103

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