Physician Advisor
Company: CHRISTUS Health
Location: Alexandria
Posted on: October 19, 2024
|
|
Job Description:
DescriptionSummary:The Physician Advisor is a full-time
administrative physician role serving CHRISTUS St. Frances Cabrini
Hospital, and its affiliates through teaching, consulting, and
advising both the Care Management Department and the medical staff
on matters regarding physician practice patterns, documentation,
over- and under-utilization of resources, medical necessity,
compliance rules and regulations, collaboration and relationships
with payers, and the community. The PA also ensures physician
support and execution for the Care Management and CDI Departments'
initiatives by promoting effective and efficient physician
documentation to support the patient's Level of Care (LOC), billing
status, and appropriateness of Medicare Severity-Diagnosis Related
Group (MS-DRG)/DRG assignment. The PA will submit monthly time
records documenting time actually spent in the provision of the
responsibilities outlined below. M-F, no call
responsibilities!Requirements:The Physician Advisor-Care Management
and Clinical Documentation Improvement role should be staffed by a
physician with the following qualifications:- 5 years of clinical
experience- Licensed physician in state of residence- Board
certified in a clinical specialty- Certified by the American Board
of Quality Assurance and Utilization Review Physicians, Inc
(ABQUARP) - preferred- Experienced in clinical practice with an
understanding of utilization review- -Served on or chaired an
Utilization Management Committee- -Demonstrated cost-efficient
practice-Physician Advisor - Care Management & CDI Duties and
ResponsibilitiesUtilization Management Plan: 20%In collaboration
with the Director of CM, lead the Utilization Review CommitteeIn
collaboration with the Director of CM, monitor key metrics for UM
and participate in action steps to achieve targets. Metrics include
(but not limited to):Denial trends, appeals & recoveriesLength of
stay- inpatient and observationCondition Code 44Physician & Staff
Education: 15%Provide education to physicians and other clinicians
related to regulatory requirements, appropriate billing status and
utilization of alternate levels of care, community resources, and
end of life care.Work with physicians to facilitate referrals to
the continuum of careFacilitate, mentor, and educate other
physicians regarding payer requirementsProvide mentoring/coaching
to UR Case Managers to increase knowledge in care
progressionEducate physicians on the benefits and importance of a
clinical documentation program and how to work with CDI
specialistsCare Management: 50%Participate in daily IDRs takes
action to expedite testing and treatment to promote efficient
patient care and appropriate LOCProvides guidance/assistance to the
Emergency Department Physicians and CM staff to ensure correct LOC
designation at intakeAct as a liaison with payers to facilitate
approvals and prevent denials or carved-out days when
appropriateParticipate in review of long-stay patients escalated
from Care Management to facilitate the use of the most appropriate
LOCReview cases that indicate a need for issuance of a hospital
notice of non-coverage determination. Discuss the case with the
attending physician and if additional clinical information is not
available, discuss the process for issuance and appeal with the
physician.Document patient care reviews, decisions, and other
pertinent information per hospital policyPossess foundational
knowledge of InterQual and MCG criteriaParticipate in Care
Management Leadership & staff meetings to help identify and
progress toward departmental goalsNotify the Care Manager of any
conflict of interest in reviewing a particular patient record.
Assist with identifying a physician to review such record.Clinical
Documentation Integrity 15%Provide feedback to physicians in each
service on clinical documentation using specific case
examples/3MHighlights/ Benefits:- Balanced professional and
personal lifestyle- Competitive compensation and benefits-
Relocation assistanceCommunity Description:- Easy drive to New
Orleans / Baton Rouge area- Easy access to local airport-
Year-round outdoor activities include golfing, hunting, fishing,
camping, hiking, and boating.- Excellent public and private
schoolsRecruiter Contact Information:Lynda CorotanEmail:Work
Type:Full Time EEO is the law - click below for more information:
We endeavor to make this site accessible to any and all users. If
you would like to contact us regarding the accessibility of our
website or need assistance completing the application process,
please contact us at .
Keywords: CHRISTUS Health, Monroe , Physician Advisor, Healthcare , Alexandria, Louisiana
Click
here to apply!
|