Physician Advisor II – MD Required

Med-Metrix

. Lead the Physician Advisor team and mentor, teach, and educate Physician Advisors internally and externally .

Posted 11/7/2026full-timeRemote • Pennsylvania • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Utilization Management, Case Reviews, and Clinical Compliance while effectively mentoring and educating Physician Advisors. Proficient in applying MCG/InterQual criteria and maintaining high standards of patient care and documentation.

Highest-signal resume keywords

Physician Advisor ExperienceUtilization Management KnowledgeMCG/InterQual Criteria ApplicationBoard CertificationInterpersonal Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Case ReviewUtilization ManagementQuality ImprovementPatient SafetyICD Code CaptureDRG AssignmentHospital EMRsMicrosoft Office SuiteDashboard ManagementClinical Documentation

Soft Skills

MentoringTeachingProblem-SolvingSound JudgmentIntegrity

Tools & Technologies

Microsoft TeamsElectronic Medical RecordsSmartphone Applications

Certifications & Qualifications

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

Industry Keywords

Clinical ReviewMedical NecessityCase Management OperationsHIPAA CompliancePatient Care Progression

About the role

Key responsibilities & impact

Lead the Physician Advisor team and mentor, teach, and educate Physician Advisors internally and externally
Perform case reviews of all case types to achieve compliance
Respond to clinical review assistance requests regarding medical necessity and other matters
Consult with attendings, nurses, and case management staff on complex clinical issues, continued-stay justification, medical necessity, and utilization management
Apply MCG/InterQual criteria and professional judgment to patient-specific cases
Support case management outcomes and clinical progression of patient care
Recommend improvements to health record documentation affecting ICD code capture, severity, acuity, risk of mortality, and DRG assignment
Participate in Physician Advisor, utilization management, care management, and related training
Meet production, quality, and performance standards
Maintain confidentiality and comply with HIPAA and information security policies
Facilitate, mentor, and educate physicians regarding payer requirements
Attend meetings and participate in peer review as requested
Manage PAOC client relationships, quarterly reports, and JOCs to support customer satisfaction and retention
Contribute to PAOC’s quality program and continuous Physician Advisor development
Educate client-facility staff on relevant topics
Mentor and train new and existing Physician Advisors for consistency and quality
Serve as Physician Advisor Team Lead for dashboard management when scheduled
Perform additional duties as assigned

Requirements

What you’ll need

Specialty Board Certified
Licensed to practice medicine in the US
3+ years working as a Physician Advisor or UR/UM Medical Director performing case reviews
Basic technical skills with Hospital EMRs, Microsoft Office, and Teams
Hold and maintain an unrestricted medical license and Board Certification
Possess or acquire a solid 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
Proficiency in Microsoft Office Suite
Strong interpersonal and communication skills
Strong problem-solving and creative skills; ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results orientation
Excellent written and verbal communication skills required
Ability to work assigned Monday–Friday shifts from 8 a.m.–5 p.m. EST to 9 a.m.–6 p.m. EST
Ability to use a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes

Benefits

Comp & perks

Holiday coverage requirement of up to 3 holidays per year
Monday to Friday assigned shifts
Remote work arrangement
Required smartphone or electronic device supplied/used for multifactor authentication and security purposes