Physician Advisor
commonspirit
Physician Advisor
About this role
Overview
GENERAL SUMMARY OF POSITION:
Under the general direction of the Medical Director, Director, or designee, the Physician Advisor is responsible for reviewing applicant medical records and making a clinical determination of eligibility for applicants seeking benefits and/or long term care services based on clinical guidelines. The Physician Advisor also provides clinical guidance reviewers and quality improvement initiatives as appropriate.
Responsibilities
MAJOR RESPONSIBILITIES:
- Responsible for determining whether an individual applying for and/or receiving public assistance benefits/services meets specific clinical and functional criteria outlined in federal and state regulations
- Review medical records, approves or denies recommendations made by Registered Nurse Reviewers regarding the status of an applicant or member
- Participates in and advises review team regarding the functional capability of an applicant based upon a comprehensive review of all records
- Contributes to quality improvement initiatives developed within the program or department
- Participates in quality team case reviews
- Collaborate with department leadership in the interpretation of all applicable regulations, development of clinical policies and quality evaluations, and provide feedback to clinical staff regarding clinical policies and the outcomes of quality evaluations
- Evaluates and develops alternatives to address problems and issues as they arise on a case by case basis
- Participates as a member of clinical or case review teams
- Responsible for training new Physician Advisors
- Performs other duties as assigned.
Qualifications
REQUIRED QUALIFICATIONS:
- Board eligible or certified in area of specialty
- Minimum of 5 years of experience in direct patient care
- Proven ability to plan and prioritize work in order to meet position objectives or job responsibilities
- Excellent problem solving and decision making capabilities
Frequently Asked Questions
What is the salary for the Physician Advisor role at umms?
The listed salary for this Physician Advisor position at umms is USD 185K–250K/yr. This is an OTHER role.
Where is the Physician Advisor position at umms located?
This Physician Advisor role at umms is based in Westborough, MA, US. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Physician Advisor role at umms full-time or part-time?
This is listed as a OTHER position. It is posted as a Physician Advisor role at umms.
How do I apply for the Physician Advisor position at umms?
Click the "Apply Now" button on this page. You will be redirected to umms's official application portal hosted on icims where you can submit your application directly.
When was the Physician Advisor job at umms posted?
This Physician Advisor position at umms was posted on Aug 10, 2026. Apply as soon as possible — early applications are often reviewed first.
Physician Advisor
umms · 💰 USD 185K–250K/yr
You'll be redirected to umms's official application page on icims.