Physician Advisor

Med-Metrix

. Perform case reviews of all case types to achieve the highest degree of compliance .

Posted 9/19/2026full-timeRemote • New Jersey • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Utilization Management, Case Management Operations, and Clinical Review processes, with a strong focus on compliance, documentation improvement, and patient care progression. Holds a valid medical license and board certification, with proficiency in MCG/InterQual criteria and hospital EMRs.

Highest-signal resume keywords

Board CertificationUtilization ManagementClinical ReviewMCG/InterQual CriteriaMicrosoft Office Suite

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Utilization ManagementClinical ReviewCase Management OperationsDocumentation ImprovementICD Code AssignmentPeer to Peer ReviewsQuality ImprovementPatient SafetyMCG/InterQual CriteriaHospital EMRs

Soft Skills

Analytical SkillsInterpersonal SkillsCommunication SkillsProblem-Solving SkillsDecision-Making Skills

Tools & Technologies

Hospital EMRsMicrosoft Office Suite

Certifications & Qualifications

Board CertificationABQAURP Board CertificationABQAURP Physician Advisor Sub-Specialty CertificationMembership in ACPA

Industry Keywords

ComplianceCase ReviewsResource ManagementLength of StayMedical NecessityPatient CareHIPAAConfidentialityPhysician AdvisorClinical Documentation

About the role

Key responsibilities & impact

Perform case reviews of all case types to achieve the highest degree of compliance
Collaborate with medical staff leadership, physicians, residents, resource management, case management, social services, discharge planning, and utilization management
Recommend methods to optimize hospital service use, length of stay, resource management, level of care, documentation, coding, and compliance
Respond promptly to clinical review assistance requests from Case Management
Consult with attendings, nurses, and case management staff on complex clinical issues, continued-stay justification, medical necessity, and utilization management
Apply MCG/InterQual criteria, professional judgment, and patient-specific variables
Support case management outcomes and clinical progression of patient care
Improve health record documentation affecting ICD code assignment, severity, acuity, risk of mortality, and DRG assignment
Participate in ongoing Physician Advisor training and education
Meet productivity, quality, and performance standards and goals
Maintain confidentiality and comply with HIPAA and information security policies
Facilitate, mentor, and educate physicians regarding payer requirements
Attend meetings requested by PAOC leadership
Participate in peer review as necessary or requested
Maintain medical licensure and board certification in good standing
Perform other duties as assigned

Requirements

What you’ll need

Board Certified and licensed to practice medicine in the US, or 3+ years active clinical experience in the US
3+ years working as a Physician Advisor performing Level of care reviews and Peer to Peer Reviews
Unrestricted medical license and Board Certification
Basic technical skills with Hospital EMRs
Foundation, knowledge, and/or experience in utilization management, quality improvement, and patient safety
Working knowledge of hospital organization, case management operations, and administrative standards and policies
Familiarity with MCG/InterQual placement status criteria preferred
Membership in the American College of Physician Advisors (ACPA) preferred
ABQAURP Board Certification preferred
ABQAURP Physician Advisor Sub-Specialty Certification preferred
Ability to effectively present information
Strong analytical skills
Proficiency in Microsoft Office Suite
Strong interpersonal, communication, problem-solving, creative, judgment, and decision-making skills
High integrity, dependability, urgency, and results orientation
Excellent written and verbal communication skills
Availability for a minimum of 16 shifts per month, including 2 weekend shifts
Ability to use a smartphone or electronic device for multifactor authentication and security purposes

Benefits

Comp & perks

Minimum of 16 shifts per month, with each shift 6–8 hours and including 2 weekend shifts per month
Required smartphone or electronic device support for multifactor authentication and security purposes