Physician Advisor – NYC Health + Hospitals – Queens Hospital Center - Queens, NY

Mount Sinai Health System•New York, NY

2d•$201,000 - $336,000•Onsite

About The Position

The Icahn School of Medicine at Mount Sinai, through its affiliation with New York City Health + Hospitals/Queens, is seeking a full-time Physician Advisor to assist with the hospital’s goals and objectives for ensuring effective use of health care resources. The Physician Advisor serves as the primary physician liaison for issues pertaining to hospital utilization, including matters pertaining to provider practice patterns, over- and under-utilization of resources, medical necessity, levels of care, care progression and length of stay management, denial management, and compliance with governmental and private payer regulations, physician documentation and coding requirements.

Requirements

MD or DO degree
Board-Certified in their respective specialty
Valid New York State License
DEA and Medicaid number
Willing to work clinically in their primary specialty
A minimum of five years medical practice experience
Solid foundation, knowledge and/or experience in utilization management and quality improvement
Knowledge of NYC Health + Hospitals’ case management operations
Strong familiarity with MCG and Interqual medical necessity criteria
Strong computer skills, including proficiency in Microsoft Excel, Epic, and Cisco WebEx

Responsibilities

Collaborate closely with case management and finance departments from across the system to identify opportunities, develop methods and implement solutions to optimize use of hospital and system resources in order to optimize quality of care and financial sustainability.
Work closely with hospital and medical departmental leadership; frontline medical staff, including attending physician staff, house staff, and advanced practice providers; and other hospital staff across all areas of resource management, case management, social services, and discharge planning, to support the development and implementation of protocols, initiatives, and training programs to optimize level of care, length of stay, supporting documentation, regulatory compliance, hospital coding, and denial management.