Physician Advisor PRN

Centra Health•Lynchburg, VA

19d

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, and patient-centered care. The role provides physician leadership across utilization management, clinical documentation integrity, care progression, regulatory compliance, and performance improvement. Working with clinical teams, operational leaders, and support departments, the Physician Advisor promotes clinical efficiency, compliance with CMS guidelines, and effective care coordination. The Physician Advisor supports the Physician Advisor Director in developing the program, including scheduling and coverage, leadership development, and budgeting. The role advises physicians on operational priorities and partners with the director and clinical teams on performance improvement related to length of stay, documentation, throughput, and cost of care. The position reviews cases for medical necessity, level of care, and length of stay; participates in multidisciplinary rounds; facilitates peer-to-peer discussions concerning medical necessity and payer disputes; and supports throughput by resolving discharge barriers. It also contributes to observation-status determinations, documentation improvement, regulatory compliance, clinician education, and initiatives that promote accountability and appropriate use of hospital resources.

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 with program development, scheduling and coverage, leadership development, and programmatic budgeting.
Act as a clinical advisor and foster alignment between physicians and operational priorities.
Partner with the Physician Advisor Director and clinical teams on performance improvement initiatives related to length of stay, documentation, throughput, and cost of care.
Support system-wide strategies in inpatient clinical optimization, clinical documentation improvement, regulatory readiness, cost-of-care management, and utilization management.
Review cases for medical necessity, appropriate level of care, and length of stay, particularly outliers.
Participate in multidisciplinary rounds to identify and mitigate care progression delays.
Facilitate peer-to-peer conversations about medical necessity determinations and payer disputes.
Identify and resolve discharge barriers to support throughput.
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 documentation-influenced quality metrics, including 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 and connect administrative and clinical priorities.
Champion initiatives that promote accountability, clinical consistency, and optimal use of hospital resources.