Job ID: 3087

Type: Physicians

State: FL

Area: Southwest Florida

Specialty: MEDICAL DIRECTOR

Description: Health system is seeking an experienced physician leader to serve as System Physician Advisor Medical Director - Full-time role (minimum 1.0 FTE); Monday–Friday 8am–4pm with one weekend per 13-week cycle for escalation coverage across all system hospitals - Onsite presence with system leadership and/or hospital staff required at least 3 days per week - Administrative assistant support provided; this role may not be combined with another administrative or clinical role Utilization & Denial Management - Oversee and optimize health system resource management, utilization management, care management, discharge planning, and social services - Review escalated medical records requiring additional insight on quality, utilization, and patient status; investigate avoidable delay concerns - Analyze and report trends related to medical necessity denials, care delays, Medicare Condition Codes 44 and W2, and payer denial patterns - Serve as physician representative in regulatory reviews including RAC and QIO audits for inpatient medical necessity - Chair the system Utilization Review Committee; collaborate with Utilization Management, Case Management, Quality Documentation, and Revenue Cycle leadership - Develop and maintain effective working relationships with payer representatives and vendors to address medical necessity denials - Collaborate with the Chief Technology Officer on technology solutions to optimize workflows Quality & Safety - Analyze and report quality, safety, and efficiency trends; collaborate with leadership to develop action plans - Support quality improvement efforts requiring clinician input; participate in system-wide readmission reduction initiatives - Member of the system Medical Executive Committee Education & Leadership - Educate and mentor clinical providers on CMS requirements, payer criteria, patient status designations, and appropriate documentation - Develop onboarding curriculum for medical staff on medical necessity, resource utilization, and collaboration with case and utilization managers (target 2027) - Provide regular reporting to COO, CMO, CNOs, CFO, and Chief Physician Executive on trends, data, and metrics - Create and maintain physician advisor schedules and contracted external advisory coverage; hold monthly meetings with physician advisor team - Drive corrective action plans for clinician outliers related to status changes and documentation compliance Requirements - Licensed MD, DO, or MBBS with active, unrestricted Florida medical license - Minimum 5 years of clinical practice experience, preferably in an inpatient hospital setting - ACPA-C or ABQAURP certification required within 12 months of hire if not already attained - Proficiency with InterQual and MCG criteria preferred; Epic experience preferred - Experience in public speaking, clinical leadership, mentorship, conflict resolution, and clinician coaching required Compensation & Benefits - Sign-on bonus and relocation package; dedicated CME time and funding - Malpractice insurance with tail coverage; short- and long-term disability - 403(b) with employer match and 457(b) enhanced retirement option; generous PTO - Eligible for Federal Public Service Loan Forgiveness Program - $336,689 - $505,024 base (sign-on will be up to 10% of first year salary)

Community/Facility info:

Contact: For more information please contact Ben Ferro at [email protected] or call 716-689-6000.