Lead Physician Advisor (T)

Ensemble Health Partners

1d

About The Position

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results. The Opportunity: By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare. The Lead Physician Advisor provides leadership for efficiently managing resource and utilization to deliver quality cost- effective care in the most appropriate setting. Works closely with the medical staff leadership, the entire medical staff, including resident physician house staff in all areas of resource/utilization management to develop and implement methods to optimize use of hospital services for all patients. This includes working with hospital leadership in developing care management protocols with physicians and others to optimize efficient management of resources, insuring patients are in the appropriate level of care, supporting documentation, coding improvements and compliance, performing Peer to Peer reviews, Short Stay Reviews, Extended Observation. Provides for medical staff education and training as required. Provides periodic reports to Board, MEC and Joint Conference as deemed necessary.

Requirements

• Leadership
• Decision Making - Makes day-to-day leadership decisions by securing and comparing information from multiple sources to identify issues; commits to an action after weighing alternative solutions against important criteria; effectively communicates decisions to the appropriate people and teams and holds them accountable. Drives results.
• Coaching & Building Talent - Achieves results through other leaders by empowering them and providing feedback, instruction and development (coaching the coach) to develop their own associates; plans and supports the growth of individual skills and abilities in preparation for their next role (building bench); focuses on retention of high performers.
• Delegation - Successfully shares authority and responsibilities with others to move decision making and accountability downward through the organization while accomplishing strategic priorities; maintains personal ownership of outcomes without excessive involvement.
• Leading Teams - Inspires and sustains team unity and engagement by developing, motivating, and guiding the team to achieve results together through productive relationships and work.
• Executive Communication - Clearly and succinctly conveys information and ideas; communicates in a focused and compelling way that captures and holds others’ attention (appropriate, impactful, and clear).
• Program/Project Management - Demonstrates high accountability and responsibility for projects and programs from inception through completion/implementation; manages budget and resource planning and awareness to ensure maximized output, reduced waste and exceptional results.
• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
• Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
• MD/DO

Responsibilities

• Maintains accountability for achieving utilization / resource management outcomes and fulfills the obligations and responsibilities of the role to support the medical staff in the clinical progression of patient care.
• Reviews issues identified by UR staff to ensure appropriate follow-up, recommend improvement initiatives as needed, and make referrals to the appropriate department chair as necessary.
• Responds to requests for assistance on clinical reviews for medical necessity or any other reason, by any member of the Utilization department in a timely fashion.
• Provides consultation to nurses and case management staff regarding complex clinical issues and advises on justification required for continued stay, medical necessity and utilization management.
• Provides for development and dissemination of required protocols, policy and procedures to support revenue cycle goals and compliance with regulations.
• Participate in ongoing training and education related to the Physician Advisor role and responsibilities including topics related to Utilization Management, Care Management and other related areas as requested.
• Obtains familiarity and working knowledge of standard published criteria such as MCG/InterQual and applies professional judgment and patient specific variables as may be necessary or justifiable.
• Facilitates local system utilization management training and education to Boards, MEC and medical staff departments as required.
• Provides for coordination and improvement in QIO audits.
• Develops statistical reports related to revenue improvement and denial reduction within scope and as requested by Local System Boards, MEC and other local system committees.
• Work with Human Resources on orientation, orientation handbook, compliance, scheduling, training, client engagement, quality and dashboards.
• Collaborate with other departments, attend company meetings and coordinate and provide updates on new processes, policies and procedures.
• Deliver bi-monthly and yearly evaluations.
• Lead weekly, quarterly meetings and develop webinar presentations.
• Grow Physician Advisory program through speaking at conferences, webcasts and podcasts.
• Collaborate with payors to establish strategies to work together.

Benefits

• Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
• Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
• Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Ph.D. or professional degree
• Number of Employees: 501-1,000 employees