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Physician Advisor

AdventHealth

Apopka, FLFull-time$207–413K/yrPosted 1w agoVerified open 4 days ago

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At a glance

Compensation
$207–413K/yr
Location
Apopka, FL
Schedule
Full-time
Work Authorization
Not specified

Requirements

Credentials this posting asks for.

Medical Doctor (MD) Or Doctor Of Osteopathic Medicine (DO) LicenseDoctorate

Job overview

AdventHealth is hiring a Physician Advisor. AdventHealth seeks a Physician Advisor who will educate and advise Utilization Management, HIM, Revenue Cycle, Patient Access, Managed Care teams, and medical staff on utilization and denial prevention, providing physician‑level review of claims and quality assurance across inpatient, outpatient and referral services while supporting CMO functions and fostering collaborative relationships.

Key focus areas include Review and authorize inpatient days, evaluate utilization patterns, and ensure appropriate inpatient/outpatient determinations., Work closely with Utilization Management staff on process improvement, case reviews, and continuity of care., and Serve as clinical liaison with attending physicians and medical staff to support decision‑making and documentation..

Successful candidates bring Doctorate, Graduate Of Accredited Medical School, and 5+ Years Clinical Practice Experience. Important skills include Relationship Building, Organizational Skills, Analytical Skills, Problem Solving, Oral Communication, and Communication. Preferred (not required): Health Plan Operations, Physician Group Leadership, Microsoft Outlook, and Microsoft Word.

Skills & qualifications

RequiredNice to have

Skills

Relationship BuildingOrganizational SkillsAnalytical SkillsProblem SolvingOral CommunicationCommunicationMatrix ManagementEthical Policy DevelopmentMedical Advisory ExpertiseHealth Plan OperationsPhysician Group LeadershipMicrosoft OutlookMicrosoft WordEthical and Legal Policy TranslationHealth Plan Operations ExperiencePhysician Group Model ExperienceLeadership ExperienceMicrosoft Office OutlookMicrosoft Office WordMicrosoft Office ExcelMicrosoft Office PowerPoint

Qualifications

DoctorateMaster's DegreeGraduate of Accredited Medical SchoolBusiness or Healthcare Administration Education5+ Years Recent Clinical Practice Experience2+ Years Physician Advisor Experience3+ Years Leadership ExperienceMedical Doctor (MD) or Doctor of Osteopathic Medicine (DO) LicenseBasic Life Support (BLS) Certification

Benefits

Medical Insurance
Dental Insurance
Vision Insurance
Paid Time Off
Parental Leave

Full job description

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

  • Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

  • Paid Time Off from Day One

  • 403-B Retirement Plan

  • 4 Weeks 100% Paid Parental Leave

  • Career Development

  • Whole Person Well-being Resources

  • Mental Health Resources and Support

  • Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

2100 OCOEE APOPKA RD

City:

APOPKA

State:

Florida

Postal Code:

32703

Job Description:

Work Location: This is a full-time, onsite position.

The Physician Advisor educates and advises Utilization Management, HIM, Revenue Cycle, Patient Access, Managed Care teams, and medical staff on updates and trends related to utilization and denial prevention. The role provides physician-level review of utilization, claims management, and quality assurance for inpatient, outpatient/observation, and referral services. It supports Chief Medical Officer functions across the region to ensure high‑quality, efficient care throughout the continuum and serves as a key contact for clinicians, payers, external providers, and regulatory entities. The Physician Advisor acts as a subject matter expert, offering clinical and business guidance to promote high‑quality, patient‑focused, cost‑effective care while maintaining respectful, collaborative relationships.

  • Reviews and authorizes inpatient days, evaluates utilization patterns, and ensures appropriate inpatient/outpatient determinations.

  • Works closely with Utilization Management staff on process improvement, case reviews, and continuity of care efforts.

  • Serves as a clinical liaison with attending physicians and medical staff to support decision-making and accurate documentation.

  • Collaborates with managed care payers and their medical directors on denials, appeals, and utilization criteria.

  • Analyzes data and trends to identify utilization improvement opportunities, develop benchmarking, and monitor outliers.

  • Provides education to physicians and clinical teams on UM protocols, regulatory changes, and documentation requirements.

  • Reviews concurrent and post-acute payer denials, intervenes with providers and payers, and supports denial prevention strategies.

  • Participates in Utilization Management and hospital committees, sharing trends and supporting quality and operational initiatives.

  • Supports organizational goals related to length of stay, quality, responsible resource stewardship, and overall performance.

  • Performs other duties as assigned.

Knowledge, Skills, and Abilities:

  • Strong ability to build and sustain relationships in the medical community and a corporate environment [Required]

  • Successful history as a practicing physician [Required]

  • Strong organization skills with attention to detail [Required]

  • Excellent analytical and problem-solving skills [Required]

  • Effective oral and written communication skills, with the ability to articulate complex information in understandable terms to all levels of staff [Required]

  • Ability to work in a matrix-management environment to achieve organizational goals [Required]

  • Ability to translate ethical and legal requirements into practical and sustainable policies, balancing the needs of the business and the interest of patients and member physicians alike [Required]

  • Ability to provide expert medical advice and explain complex medical situation [Required]

  • Health plan experience in operations [Preferred]

  • Experience in a physician group model, leadership experience [Preferred]

  • Effective computer skills, particularly Microsoft Office Outlook, Word, Excel, PowerPoint [Preferred]

Education:

  • Doctorate [Required]

  • Master's [Preferred]

Field of Study:

  • Graduate of an accredited Medical School

  • in Business or Healthcare Administration

Work Experience:

  • 5+ years recent clinical practice experience [Required]

  • 2+ years or greater experience as a Physician Advisor [Preferred]

  • 3+ years of leadership experience [Preferred]

Licenses and Certifications:

  • Medical Doctor (MD) [Required] OR Doctor of Osteopathic Medicine (DO) [Required]

  • Basic Life Support (BLS) [Preferred]

Physical Requirements: (Please click the link below to view work requirements)

Pay Range:

$206,606.17 - $413,212.34 Background Screening Requirement (Florida Law)

Certain positions are subject to Florida Level 2 background screening , including fingerprinting, as required by state law.

Applicants may review general information about Florida’s background screening requirements at the Florida Care Provider Background Screening Clearinghouse : https://info.flclearinghouse.com/

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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