JOB SUMMARY
The Sr. Physician Advisor is a key member of the healthcare organization's leadership team and is responsible for meeting the organization's goals and objectives for assuring the effective, efficient utilization and quality of healthcare services.
The Sr. Physician Advisor is a physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital and physician leadership.
The Sr. Physician Advisor shall develop expertise on matters regarding physician practice patterns, over and under-utilization of resources, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, appropriate physician coding, and documentation requirements.
The Sr. Physician Advisor will provide support to the Operational VP and Director of Care Management and the Utilization Functions in meeting the organizational strategic imperatives, goals, and operations.
Qualifications
EDUCATION REQUIREMENTS
Doctorate Degree in Medical Field (Required)
EXPERIENCE REQUIREMENTS
- Possess or acquires a solid foundation, knowledge, and / or experience in the areas of utilization management, quality improvement, clinical documentation improvement, and patient safety. (Required)
- Possess a working knowledge of Phoebe Health System organization & case management operations and administrative standards and policies. (Required)
- Strong computer skills and working knowledge of the EMR. (Required)
- Familiarity with MCG / Interqual placement status criteria (Preferred)
- Member of the American College of Physician Advisors (ACPA) (Preferred)
- Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) (Preferred)
- Ability to build rapport with medical staff and hospital leadership to obtain the buy-in and collaboration necessary to achieve desired outcomes (Required)
- Ability to provide medical guidance and support to the VP of Patient Logistics and Care Coordination as well as the Director(s) of Care Management and Phoebe Care Command in meeting operational goals and strategic imperatives. (Required)
CERTIFICATIONS AND LICENSURES
- Required Certifications / Licensures : Licensed Physician in the state of Georgia (Unrestricted)
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