Physician Advisor Clinical Assistant Professor (HS)

Are you looking to take your career to new heights with a leader in healthcare SUNY Downstate Health Sciences University is one of the nations leading metropolitan medical centers. As the only academic medical center in Brooklyn we serve a large population that is among the most diverse in the world. We are also highly-ranked by Castle Connolly Medical a healthcare rating company for consumers among the top 5 leading U.S. medical schools for training doctors.

Bargaining Unit : UUP

Job Summary :

The Department of Medicine at SUNY Downstate Health Sciences University is seeking a full-time Physician Advisor / Clinical Assistant Professor (HS).

The Physician Advisor plays a critical role in optimizing healthcare delivery by providing guidance on medical necessity utilization management and quality improvement initiatives. They collaborate with healthcare teams to ensure compliance with regulatory standards and promote cost-effective care delivery. This is a full-time (part-time arrangements may be considered) position reports to the Chief Medical Officer.

Key Responsibilities

• Utilization Review :

Review medical records and documentation to assess the appropriateness of services rendered and ensure compliance with regulatory guidelines.

Evaluate the medical necessity of procedures treatments and hospital admissions / level of care (inpatient vs. observation) based on established criteria and guidelines.

Collaborate with case managers social work and healthcare providers to develop care plans that meet patients clinical needs while optimizing resource utilization to improve length of stay. Work with the other stakeholders to optimize IDR.

Lead the denial appeal process to optimize the resolution of insurance denials by providing clinical expertise and supporting appeals processes.

Provide education and training to healthcare professionals on utilization management principles documentation requirements and regulatory compliance.

Collaborate with CDI to ensure appropriate physician documentation with a goal to improve utilization CMI and risk adjusted quality measures.

Work closely with physicians nurses administrators and other stakeholders to promote effective communication and coordination of care.

Contribute to the development and revision of utilization management policies protocols and procedures.

Monitor and evaluate key performance indicators related to utilization management quality of care and financial outcomes.

Required Qualifications :

Preferred Qualifications :

Work Schedule :

Variable Days; Variable Hours (Full-Time)

Salary Grade / Rank :

S alary Range :

Commensurate with experience and qualifications

E xecutive Order :

Pursuant to Executive Order 161 no State entity as defined by the Executive Order is permitted to ask or mandate in any form that an applicant for employment provide his or her current compensation or any prior compensation history until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time please contact the Governors Office of Employee Relations at or via email at .

Equal Employment Opportunity Statement :

SUNY Downstate Health Sciences University is an affirmative action equal opportunity employer and does not discriminate on the basis of race color national origin religion creed age disability sex gender identity or expression sexual orientation familial status pregnancy predisposing genetic characteristics military status domestic violence victim status criminal conviction and all other protected classes under federal or state laws.

Women minorities veterans individualswith disabilities and members of underrepresented groups are encouraged to apply.

If you are an individual with a disability and need a reasonable accommodation for any part of the application process or in order to perform the essential functions of a position please contactHuman Resources at

Required Experience :

Unclear Seniority

Key Skills

EMR Systems,Occupational Health Experience,Pain Management,Acute Care,Physical Examinations,Physiology Knowledge,Primary Care Experience,Suturing,Workers' Compensation Law,Dermal Fillers,Medical Imaging,Botox Experience

Employment Type : Full-Time

Experience : years

Vacancy : 1