Physician Advisor
commonspirit
OTHER
Physician Advisor
hurc· CUR
About this role
The Physician Advisor provides physician-to-physician reviews, clinical guidance, education, and escalation support while promoting evidence-based practices and appropriate resource utilization.
Key Responsibilities
- Conduct physician-to-physician reviews for medical necessity, level of care, and denial prevention/appeals
- Support utilization review and case management teams with complex clinical decision-making
- Ensure appropriate admission status determinations (inpatient vs. observation) in alignment with CMS and payer guidelines
- Provide clinical oversight related to length of stay, care progression, and discharge planning
- Ensure adherence to CMS Conditions of Participation, Medicare regulations, and payer policies
- Support compliance with medical necessity criteria (InterQual, MCG, or equivalent)
- Assist with audit preparedness and response, including RAC, MAC, and commercial payer audits
- Partner with HIM/CDI teams to improve documentation quality and clinical accuracy
Education & Physician Engagement
- Serve as a trusted peer resource to attending physicians and advanced practice providers
- Educate medical staff on regulatory requirements, utilization best practices, and documentation standards
- Support change management initiatives related to clinical operations and compliance
Qualifications
Required
- MD or DO with an active, unrestricted medical license
- Board-certified or board-eligible in a recognized specialty
- Clinical practice experience in an acute care or relevant healthcare setting
- Strong knowledge of utilization management, medical necessity, and payer regulations
- Excellent communication skills with the ability to conduct peer-to-peer discussions
Preferred
- Prior experience as a Physician Advisor, Medical Director, or in Utilization Review
- Familiarity with CMS guidelines, InterQual, MCG, and denial management processes
- Experience working with case management, CDI, HIM, or revenue cycle teams
- Experience in a remote or consulting healthcare environment
Skills & Competencies
- Physician-to-physician negotiation and collaboration
- Clinical judgment balanced with regulatory and financial awareness
- Data-driven decision-making
- Ability to influence without authority
- Strong written and verbal communication
Frequently Asked Questions
Is the salary disclosed for the Physician Advisor position at hurc?
The salary for this Physician Advisor role at hurc is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Is the Physician Advisor job at hurc remote?
Yes, this Physician Advisor position at hurc is remote, with team members based in Remote, Short Hills, New Jersey, United States. You can work from home or anywhere in the supported regions.
Is the Physician Advisor role at hurc full-time or part-time?
This is listed as a Contractor position. It is posted as a Physician Advisor role in the CUR department at hurc.
Which team or department does the Physician Advisor at hurc belong to?
This Physician Advisor position is part of the CUR department at hurc. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Physician Advisor position at hurc?
Click the "Apply Now" button on this page. You will be redirected to hurc's official application portal hosted on bamboohr where you can submit your application directly.
When was the Physician Advisor job at hurc posted?
This Physician Advisor position at hurc was posted on Apr 6, 2026. Apply as soon as possible — early applications are often reviewed first.
Physician Advisor
hurc
You'll be redirected to hurc's official application page on bamboohr.