Offer summary

Qualifications:

MD or DO degree from an accredited institution., Active and unrestricted medical license in Florida., Minimum of 3–5 years of clinical experience, preferably in hospital or internal medicine., Strong knowledge of CMS regulations, medical necessity criteria, and clinical documentation standards..

Key responsibilities:

Serve as a liaison between medical staff, Case Management, and administration to resolve utilization issues.

Ensure documentation supports clinical validation, coding, and medical necessity.

Review and guide placement decisions based on severity of illness and risk of mortality.

Monitor hospital utilization metrics like length of stay and re-admissions.

Job description

Physician Advisor (Administrative Role)

Boynton Beach, FL
Full-Time | Hybrid Remote | Day Shift

We are seeking a knowledgeable and experienced Physician Advisor (PA) to join our administrative team in Boynton Beach, FL. This is a full-time, hybrid remote position with a daytime schedule, offering a unique opportunity to combine clinical expertise with healthcare leadership and system improvement.

As a key member of the medical leadership team, the Physician Advisor will serve as a clinical and compliance resource for physicians, case managers, and other key departments. The PA will work to ensure medical necessity, documentation integrity, proper utilization, and regulatory compliance throughout the patient care continuum.

Position Summary:

The Physician Advisor works collaboratively with the medical staff, Case Management (CM), Social Work (SW), and hospital leadership to address critical areas including documentation accuracy, clinical validation, coding support, hospital utilization, and compliance with state and federal regulations. The PA plays a central role in improving the efficiency, quality, and financial sustainability of hospital operations.

This position operates under a matrix reporting structure, reporting to the Corporate Physician Advisor, Corporate Chief Quality and Innovation Officer (CQIO), as well as the Chief Medical Officer (CMO) and Chief Executive Officer (CEO) of the facility.

Compensation and Benefits:

Competitive compensation
Health, Dental, Vision
Full Office Support Staff

Qualifications:

MD or DO degree from an accredited institution.
Active and unrestricted medical license in Florida.
Minimum of 3–5 years of clinical experience; experience in hospital medicine, internal medicine, or utilization review preferred.
Prior experience as a Physician Advisor or in a related administrative/utilization management role is strongly preferred.
Strong knowledge of CMS regulations, medical necessity criteria (e.g., InterQual, MCG), and clinical documentation standards.
Excellent communication, negotiation, and collaboration skills.
Comfortable working in both on-site and remote environments.

Key Responsibilities:

Serve as a liaison between medical staff, Case Management, and administration to resolve utilization management issues.
Ensure documentation supports clinical validation, coding, and medical necessity.
Review and guide placement decisions for appropriate level of care (e.g., inpatient, observation) based on severity of illness and risk of mortality.
Monitor and help manage length of stay, re-admissions, and other hospital utilization metrics.
Ensure compliance with CMS guidelines for appropriate billing practices and level-of-care determinations.
Provide real-time consultation to admitting physicians and interdisciplinary teams to support proper clinical documentation.
Conduct post-discharge reviews and assist in responding to payer audits and denials.