Physician Advisor Job Description [Updated for 2025]

In the ever-evolving healthcare industry, the role of Physician Advisors has become increasingly significant.

As medical science progresses, the need for seasoned professionals who can guide, strategize, and uphold our healthcare standards continues to grow.

But let’s delve deeper: What’s truly expected from a Physician Advisor?

Whether you are:

• A job seeker trying to understand the core of this role,
• A hiring manager drafting the perfect candidate profile,
• Or simply fascinated by the intricacies of healthcare management,

You’ve come to the right place.

Today, we present a customizable Physician Advisor job description template, designed for seamless posting on job boards or career sites.

Let’s dive right in.

Physician Advisor Duties and Responsibilities

Physician Advisors play a vital role in the healthcare sector, particularly in hospitals and other healthcare facilities.

They ensure that patients receive appropriate care and they provide guidance to healthcare providers on medical necessities and compliance with policies and regulations.

Physician Advisors have the following duties and responsibilities:

• Evaluating the necessity, appropriateness, and efficiency of medical services and procedures
• Consulting with medical staff to ensure compliance with healthcare regulations and standards
• Serving as a liaison between the hospital administration and the medical staff
• Providing education to healthcare providers regarding regulatory requirements and medical necessity
• Collaborating with case management, quality improvement, and compliance teams
• Providing expert advice on medical treatment to optimize patient care
• Reviewing patient records and evaluating the adequacy and appropriateness of documentation
• Assisting in the development and implementation of clinical and patient care policies and protocols
• Participating in committees and meetings related to patient care, quality improvement, and regulatory compliance

 

Physician Advisor Job Description Template

Job Brief

We are seeking a knowledgeable and dedicated Physician Advisor to join our team.

The Physician Advisor will act as a liaison between the clinical staff and hospital administration, ensuring compliance with regulations and aiding in the maximization of care management efforts.

The ideal candidate should have excellent analytical abilities, superior knowledge in health care regulations, an understanding of medical coding and billing, and strong communication skills.

 

Responsibilities

• Provide clinical expertise to the care management and utilization review team.
• Advise on matters regarding physician practice patterns, appropriate utilization of resources, and regulatory compliance.
• Collaborate with medical staff to develop and implement effective strategies for compliance with healthcare regulations.
• Assess medical records for compliance with coverage and care guidelines.
• Assist with the development and implementation of policies and procedures.
• Train medical staff on coding and documentation requirements.
• Collaborate with care management teams to ensure efficient patient flow.
• Participate in quality improvement initiatives.

 

Qualifications

• Medical degree and board certification in a recognized specialty.
• Current licensure to practice medicine in the state.
• Extensive clinical experience in a hospital setting.
• Strong understanding of clinical utilization review and healthcare regulations.
• Knowledge of current medical coding and billing practices.
• Excellent communication and interpersonal skills.
• Strong leadership abilities and a collaborative approach to problem-solving.
• Experience in health administration would be advantageous.

 

Benefits

• 401(k)
• Health insurance
• Dental insurance
• Retirement plan
• Paid time off
• Continuous professional development opportunities

 

Additional Information

• Job Title: Physician Advisor
• Work Environment: Hospital setting with the possibility of some remote work. Some local travel may be necessary for training or meetings.
• Reporting Structure: Reports to the Medical Director or Chief Medical Officer.
• Salary: Salary is based upon candidate experience and qualifications, as well as market and business considerations.
• Pay Range: $200,000 minimum to $300,000 maximum
• Location: [City, State] (specify the location or indicate if remote)
• Employment Type: Full-time
• Equal Opportunity Statement: We are an equal opportunity employer and value diversity in our hospital. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
• Application Instructions: Please submit your resume and a cover letter outlining your qualifications and experience to [email address or application portal].

 

What Does a Physician Advisor Do?

Physician Advisors typically work in healthcare facilities such as hospitals, clinics, and nursing homes.

They can also work as consultants for healthcare organizations or insurance companies.

Their role involves liaising between hospital administration and medical staff, bridging gaps and promoting understanding of administrative rules and regulations among healthcare professionals.

They are responsible for reviewing medical cases and providing expert advice on appropriate levels of care.

This can include determining the necessity of procedures, medication usage, admission status, and length of stay, based on a thorough understanding of clinical guidelines and regulations.

Physician Advisors also play a key role in reviewing, developing and implementing medical policies and procedures.

They ensure the use of best practices and evidence-based medicine in patient care to improve healthcare outcomes.

They participate in performance improvement initiatives and may be involved in medical staff training and education.

Their role also often involves collaboration with other healthcare professionals such as case managers, nurses, and social workers.

Furthermore, they assist in audits and appeals related to medical necessity, billing, coding, and claims denials, safeguarding the financial health of the healthcare organization while advocating for patient’s rights and needs.

Physician Advisors contribute significantly to the effective functioning of the healthcare system, ensuring the delivery of high-quality patient care that aligns with regulatory guidelines and fiscal responsibilities.

 

Physician Advisor Qualifications and Skills

A proficient Physician Advisor should possess a range of skills and qualifications that align with the job description, which includes:

• Strong clinical knowledge and expertise to provide insight and guidance on healthcare related matters.
• Exceptional interpersonal and communication skills to interact with medical staff, patients, and insurance companies, explaining complex medical information in simple terms.
• Profound understanding of healthcare regulations and medical coding practices to ensure compliance with national and local standards.
• Excellent leadership skills to guide and influence medical staff, implementing changes that improve patient care and streamline healthcare delivery.
• Problem-solving abilities to address and resolve issues pertaining to patient care, resource allocation, and policy implementation.
• Proficient in using Electronic Health Record (EHR) systems and other medical software for documentation, patient tracking, and reporting.
• Ability to conduct utilization review processes and assess the necessity, appropriateness, and efficiency of the use of medical services, procedures, and facilities.
• Strong ethical and professional standards, always adhering to patient confidentiality and privacy rules.

 

Physician Advisor Experience Requirements

Physician Advisors are typically seasoned medical professionals who have substantial clinical experience, often with a minimum requirement of 5 to 7 years in a patient care setting.

This experience provides them with the necessary medical knowledge to advise effectively on issues related to patient care, clinical efficiency, and regulatory compliance.

Many hospitals and healthcare organizations prefer Physician Advisors who have prior experience in a similar role, particularly in understanding and applying medical necessity criteria and reviewing utilization management practices.

Experience in leadership roles or management can also be beneficial, as Physician Advisors often interact with diverse healthcare teams and need to have strong communication and team-building skills.

Physician Advisors are often required to have experience in medical coding, billing, and compliance with healthcare regulations.

Lastly, a Physician Advisor should have experience in medical informatics and data analysis, as they often need to interpret and present data related to patient care and clinical operations.

Continuing education and staying updated with the latest medical guidelines, practices, and regulations are also part of the ongoing experience requirements for this role.

 

Physician Advisor Education and Training Requirements

To become a Physician Advisor, one typically needs to hold a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree.

This is followed by a residency in a specialized area such as internal medicine, family medicine, or pediatrics, which may take 3-7 years depending on the specialty.

It’s highly recommended for a Physician Advisor to be board-certified in their specialty, which denotes that they have successfully completed the rigorous examination and review process of their respective medical specialty board.

Several years of clinical experience is also crucial before transitioning into an advisory role.

The physician advisor should have an in-depth understanding of healthcare delivery systems, utilization management, and medical necessity criteria.

Moreover, knowledge in relevant areas such as health law, medical coding, billing, and clinical documentation is also beneficial.

Some Physician Advisors may also pursue a Master’s in Healthcare Administration or Business Administration to better understand the administrative and financial aspects of healthcare.

Continued medical education (CME) is required to maintain licensure and board certification.

Furthermore, being updated with the latest healthcare regulations, policies, and trends is crucial for this role.

Optional certifications such as the Certified Physician Advisor (CPA) offered by the American Board of Quality Assurance and Utilization Review Physicians can further validate the skills and knowledge of a Physician Advisor.

These certifications typically require ongoing education and periodic re-certification.

 

Physician Advisor Salary Expectations

A Physician Advisor can expect to earn an average salary of $215,000 (USD) per year.

This salary can vary based on factors such as years of experience, geographic location, the size and type of healthcare facility, and any additional specializations or qualifications held by the individual.

 

Physician Advisor Job Description FAQs

What qualifications does a Physician Advisor need?

A Physician Advisor should be a board-certified physician with a valid state license and several years of medical practice experience.

They should have a deep understanding of the healthcare system and legal and regulatory requirements.

Knowledge in hospital administration and case management can also be advantageous.

 

What are the typical duties of a Physician Advisor?

The duties of a Physician Advisor include reviewing patient medical records and assisting in making care decisions.

They serve as a liaison between the medical staff and administration, provide advice on medical necessity and appropriateness of hospitalization, and help in the development of treatment guidelines.

They also play a role in educating physicians and staff about regulatory compliance and changes in healthcare regulations.

 

What skills does a Physician Advisor need?

A Physician Advisor needs strong analytical skills to review and interpret medical data.

They also need excellent communication skills to interact with physicians, nurses, and hospital administrators.

They must have the ability to make informed decisions about patient care, and a deep understanding of medical regulations and guidelines.

Leadership and problem-solving skills are also essential.

 

How can a Physician Advisor impact hospital operations?

A Physician Advisor can greatly impact hospital operations by ensuring that the care provided is both medically necessary and carried out in the most appropriate setting.

They can assist in reducing costs, minimizing risks, and improving the quality of patient care.

Their guidance can also help the hospital remain compliant with changing healthcare regulations, and they can aid in resolving disputes related to patient care.

 

What are the career growth opportunities for a Physician Advisor?

Physician Advisors may consider specializing in a particular area like pediatrics or geriatrics to bring more value to their role.

They can also take on more administrative responsibilities, leading to roles such as Medical Director or Chief Medical Officer.

Additional education in healthcare administration or management can also open up more opportunities.

 

Conclusion

So, there you have it.

Today, we’ve unveiled the true essence of being a physician advisor.

Surprised?

It’s not just about providing medical guidance.

It’s about shaping the future of healthcare, one patient at a time.

With our comprehensive physician advisor job description template and real-life examples, you’re ready to take your next step.

But why limit yourself?

Explore further with our job description generator. It’s your gateway to creating meticulous job listings or refining your resume to brilliance.

Remember:

Every piece of advice is a step towards improved patient care.

Let’s shape healthcare. Together.