Lead hospital utilization management, clinical documentation integrity, and care progression efforts for a large academic medical center in a fully administrative physician leadership role. The work centers on improving throughput, reducing length of stay, preventing denials, and supporting accurate coding and reimbursement. This role also involves mentoring clinicians and partnering with operational leaders using Epic dashboards, predictive analytics, and AI-supported tools.
Key Responsibilities
- Provide senior physician leadership and advise the Chief Medical Officer on utilization and documentation strategy.
- Lead the Physician Advisor team and oversee utilization review activities.
- Drive utilization management, clinical documentation integrity, and denial prevention workflows.
- Coordinate efforts to improve throughput, length of stay, compliance, and reimbursement accuracy.
- Use Epic-based dashboards, predictive analytics, and AI-enabled tools to support documentation and coding improvement.
- Develop and deliver education for medical staff, residents, and advanced practice providers.
- Collaborate with hospital leaders on quality, safety, financial performance, and payer-related strategy.
Required
- MD or DO degree.
- Active New Jersey medical license.
- At least 10 years of hospital-based clinical experience.
- Experience in utilization management, clinical documentation, or case management.
- Strong knowledge of CMS regulations, including the Two-Midnight Rule.
Preferred
- Prior experience as a Physician Advisor or Medical Director in UM/CDI.
- Experience with Epic and AI-enabled UM/CDI tools.
- Formal performance improvement training.
Benefits & Perks
- 100% administrative physician leadership role.
- Opportunity to lead and mentor a dedicated physician advisor team.
- Access to Epic-enhanced dashboards, predictive analytics, and AI-supported tools.
- Comprehensive benefits package, including health, dental, vision, tuition reimbursement, and retirement benefits.
- Minimum base salary of $430,000, with final compensation discussed during the interview process.