Physician Advisor, Utilization Review and Care Management

Job overview

The Physician Advisor, Utilization Review and Care Management role is onsite in Utica, NY. Compensation is not specified. The position supports Mohawk Valley Health System’s care management and physician teams in advancing clinical quality and operational efficiency. The physician reviews cases and advises care teams on level of care, patient status, resource use, and discharge barriers. The role also supports regulatory compliance and improved clinical and financial outcomes through documentation guidance, education, and outcome tracking.

What you'll do

• Educate physicians on documentation for admission appropriateness, continued stay, severity, and morbidity and mortality
• review patient status when admission criteria are insufficient
• monitor observation status and the 2nd Midnight rule across payor types
• perform concurrent review and escalate cases not meeting criteria
• advise on palliative, end-of-life, and hospice care
• track and trend outcome KPIs and provide education based on trends and regulatory changes.

What we're looking for

Skills & competencies

physician advisor

utilization review

care management

utica ny

mohawk valley health system

clinical case review

patient status

discharge planning

regulatory compliance

clinical documentation

Work arrangement

• Weekend coverage required

Why this role

Combines clinical case review, regulatory compliance, documentation education, and resource utilization guidance.

About the employer

Mohawk Valley Health System is hiring for this role. Industry: Offices of Physicians (except Mental Health Specialists). Sector: 62.