Physician Advisor
About The Position
The 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
- MD/DO Physician (MUST have)
Responsibilities
- Status determinations for hospitalized patients
- Perform peer to peers with payors’ medical directors
- Short inpatient stay reviews
- Review observation patients daily
- Build relationship with medical staff and leadership to get their buy-in with UM issues
- Attend UM Committees as subject matter expert
- Assist with denials and appeals as appropriate
- Educate medical staff on UM topics
- Partner with UR nurses, IA staff, and Case Management to maintain and improve upon the UM process
- Track denial trends to assist the team evolve to meet new payor challenges
Benefits
- healthcare
- time off
- retirement
- well-being programs
- professional certification relevant to their field
- tuition reimbursement
- quarterly and annual incentive programs
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
Ph.D. or professional degree
