Behavioral Health Physician Advisor; Remote

Overview

Carle Health is seeking a Physician Advisor to help oversee the efficiency of care for our Behavioral Health team across the West, Central, and East regions in Central Illinois.

• Part‑time position (.5 FTE, 100% virtual)
• Conduct clinical case reviews referred by the Utilization Management Team, the Case Management Team, the Clinical Denial Management Team, and other healthcare professionals.
• Participate in discussions with payer physicians to ensure efficient and appropriate utilization of hospital services for the assigned patient population.
• Serve as a consultant and resource for attending physicians in individual settings and group meetings such as hospitalist meetings regarding hospital utilization, appropriate level of care, and continued stays.
• Participate in regular scheduled and ad‑hoc meetings related to utilization management, case management, and clinical denial management.
• Onboard new providers regarding utilization and case management objectives.
• Conduct medical record reviews for medical necessity of hospital admission, continued stay, adequacy of discharge planning, and quality care management.
• Provide education to physicians and other clinicians on improved documentation, regulatory requirements, appropriate utilization, alternative levels of care, and community resources.
• Collaborate with the Clinical Denial Management team and the Utilization Management team to defend payer claims denials through coordination and participation in the appeal process.
• Work under the authorization of the Chief Medical Officer and with the Utilization Management RN team, Clinical Denials Management team, and the Physician Advisor Team (5 other physicians).
• Conduct clinical reviews on cases referred by Care Management staff, Utilization Management, Clinical Denials Team, and other healthcare professionals in line with the hospital's objectives for quality patient care, efficient utilization, appropriate level of care, and regulatory compliance.
• Interact with Medical Staff members, APP Directors, and Medical Directors of payers to discuss patients’ needs and alternative levels of care.
• Act as consultant and resource to attending physicians regarding hospitalization decisions, continued stay, and resource use.
• Act as consultant and resource to the Medical Staff regarding federal and state utilization and quality regulations.

• MD/DO, board‑certified in Psychiatry
• Active Illinois medical license or ability to obtain
• 5+ years of psychiatric clinical practice experience
• 1–2 years experience as a Physician Advisor or in a similar role

Champaign‑Urbana is a micro‑urban community offering the amenities of a larger city with the feel of a smaller town. Located equidistant to Chicago, St. Louis, and Indianapolis, the area provides excellent schools, a vibrant downtown, the University of Illinois, Big 10 sports, and a lively college‑town atmosphere, including the Krannert Center for the Performing Arts.

Carle Health is a healthcare system with nearly 16,600 team members across eight hospitals, physician groups, and various businesses. Our hospitals—Carle Bro Menn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center—hold Magnet® designations. The system also includes Methodist College and Carle Illinois College of Medicine, the world’s first engineering‑based medical school.

The compensation for this position is $160 per hour, representing a good‑faith minimum and maximum range for the role at the time of posting. The actual compensation may vary based on experience, qualifications, location, training, licenses, shifts, and model. Carle Health offers a comprehensive benefits package for team members and providers.