Physician Advisor PRN

Centra Health•Lynchburg, VA

20d

About The Position

The Physician Advisor serves as a bridge between clinical practice and operational excellence, supporting Centra Health’s goals of delivering high-quality, cost-effective, patient-centered care. The role provides physician leadership across utilization management (UM), clinical documentation integrity (CDI), care progression, regulatory compliance, and performance improvement. Working with clinical teams, operational leaders, and support departments, the Physician Advisor promotes clinical efficiency, CMS compliance, and effective care coordination.

Requirements

MD or DO degree.
Active board certification in a clinical specialty.
Current license to practice medicine in Virginia.
Minimum 3–5 years of clinical practice experience.

Responsibilities

Support the Physician Advisor Director in building the comprehensive program, including scheduling and coverage support, leadership development, and programmatic budgeting.
Act as a trusted clinical advisor and foster alignment between physicians and operational priorities.
Partner with the Physician Advisor Director to lead performance improvement initiatives related to length of stay, documentation, throughput, and cost of care.
Support system-wide strategies for inpatient clinical optimization, clinical documentation improvement, regulatory readiness, and cost-of-care management.
Review cases for medical necessity, appropriate level of care, and length of stay, especially outliers.
Participate in multidisciplinary rounds to identify and mitigate care progression delays.
Facilitate peer-to-peer conversations regarding medical necessity determinations and payer disputes.
Support throughput efforts by identifying and resolving discharge barriers.
Provide input on observation status determinations and ensure appropriate clinical documentation.
Engage physicians to improve documentation accuracy, specificity, and timeliness.
Collaborate with CDI and coding teams on quality metrics influenced by documentation, such as PSI-90 and SOI/ROM.
Review query response trends and support escalation or education as needed.
Educate clinicians on CDI principles, DRG optimization, and coding best practices.
Ensure compliance with CMS Utilization Management requirements, including Conditions of Participation and relevant policies.
Support development and implementation of UM plans, committee structures, and documentation workflows aligned with federal and state regulations.
Monitor performance and recommend process improvements for compliance and efficiency.
Translate data into actionable insights for clinical teams, connecting administrative and clinical priorities.
Champion initiatives that promote accountability, clinical consistency, and optimal use of hospital resources.