System Physician Advisor
Partnering for a stronger, healthier world.
At CommonSpirit Health, we believe in the healing power of humanity. We invite you to explore our specialty areas and pursue a career in humankindness.
- Department: Hospitalist
The posted compensation range of $79.24 - $114.89 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
Job Details
Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings. CommonSpirit has more than 157,000 employees, 45,000 nurses and 25,000 physicians and advanced practice providers across 24 states and contributes more than $4.2 billion annually in charity care, community benefits and unreimbursed government programs. Together with our patients, physicians, partners, and communities, we are creating a more just, equitable, and innovative healthcare delivery system.
Responsibilities
This is a remote position and you must be licensed in the state of Texas.
As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred by case management staff and/or other health care professionals to meet regulatory requirements and, in accordance with the hospital’s objectives for providing quality patient care, to assure effective and efficient utilization of health care services. The PA communicates remotely with case and utilization management to discuss selected cases and make recommendations regarding level of care, as well as, communicates remotely with medical staff members and medical directors of third-party payers to discuss the needs of patients and options/alternatives for care. The PA acts as a consultant to, and resource for, attending physicians regarding their decisions relative to appropriateness of hospitalization, appropriate level of care for initial hospitalization and continued stay days, clinical documentation, and use of healthcare resources. The PA further acts as a resource for the medical staff regarding federal and state utilization and quality regulations. The PA must demonstrate interpersonal and communication skills and must be clear, concise and consistent in the message to all constituents.
Key Responsibilities
- Conducts medical record review in appropriate cases for medical necessity of hospital admission, continued hospital stays, adequacy of discharge planning and quality care management.
- Understand the intricacies of the Medicare Inpatient Prospective Payment System (IPPS) to make medical determinations on severity of illness, acuity, risk of mortality, and communicate with treating physicians in cooperation with the utilization team and health information staff.
- Understand the intricacies of ICD-9-CM, ICD-10-CM/PCS, MS-DRG, and APR-DRG.
- Contacts Case and Utilization Management Teams: Makes telephonic/electronic contacts with case and utilization management to discuss clinical aspects of hospital encounters, as well as, medical necessity and appropriate levels of care.
- Contacts Attending Physicians: Makes telephonic/electronic contacts with Attending Physicians to discuss clinical aspects of hospital encounters, as well as,medical necessity and appropriate levels of care. Discussion may also include education for improved clinical documentation, in addition to, governmental and commercial guidelines for reimbursement.
- Conducts Peer to Peer discussions with payers as needed.
Qualifications
- MD or DO required
- Unrestricted license in field of practice in the state of Texas required.
- Minimum of 1 year of experience as a Physician Advisor preferred.
- Minimum of 5 years of clinical practice required.
- Experience performing Peer to Peer Reviews, preferred
- Broad-based knowledge regarding clinical practice.
- Broad knowledge base with trust and respect of medical staff physicians.
- In-depth knowledge of CMS regulations, including understanding of the 2-midnight rule.
- Utilization management experience.
- Education in quality and utilization management through continuing medical education programs and self-study.
- Knowledge of and practical use of good business English, spelling, arithmetic, practices and the ability to communicate effectively using written and verbal skills.
#LI-CSH
#LI-Remote
Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.
Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.
Nursing excellence
starts with you.
Are you a career fit with our CommonSpirit Health culture? To understand how we are structured, we believe in some core philosophies with the following:
We will be stronger together, achieving excellence in all we do, collaborating across the fields and growing our collective knowledge.
We will let humankindness guide us as we treat every person with holistic, personalized care for the body, mind and spirit.
We will advance the science and art of nursing as innovative leaders who demonstrate the power of evidence-based, compassionate care. If you believe in working together with humankindness for all to advance the science and art of nursing - then you have found your career fit with us!
“Our hope is that you will always feel inspired, knowing you truly are the heart and soul of CommonSpirit.”
– Kathleen D. Sanford, EVP, Chief Nursing Officer
Your Potential Career Path
This is a snapshot of your potential career path highlights the series of job positions that help you progress towards your goals and objectives. Ultimately, your career path depends on your career values and personal goals.

Success Profile
What makes a successful Physician at CommonSpirit Health?
- Compassionate
- Trustworthy
- Proactive
- Collaborative
- Communicator
- Balanced
Our Total Reward Offerings
At CommonSpirit Health, we believe investing in our employees lets them know they truly matter. Your Total Rewards package includes compensation, benefits, retirement, wellness, leave, and other programs.
-
Pay and Recognition
-
Balanced Life
-
Well-Being
-
Professional Growth
-
Financial Future
-
Dependent Care
No recently viewed jobs
You have no saved Jobs
Join our Talent Community so you can stay connected and be alerted to future opportunities.
Get Started