Description
Description
The Physician Advisor is charged with meeting the organizations goals and objectives for assuring the effective, efficient utilization of health care services. The Physician Advisor is a physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership. The 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 Physician Advisor works closely with the medical staff leadership, the entire medical staff, including resident physician house staff, all areas of resource management, case management, social services, discharge planning, and utilization management to develop and implement methods to optimize use of hospital services for all patients while also ensuring the quality of care provided. This includes working with hospital leadership in developing care management protocols with physicians and others to optimize length of hospital stay and efficient management of resources, insuring patients are in the appropriate level of care, supporting documentation, coding improvements and compliance, and monitoring the appropriate use of diagnostic and therapeutic modalities.
Preferred qualifications
- Member of the American College of Physician Advisors (ACPA)
- Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP)
- Physician Advisor Sub-Specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP).
Qualifications
- Certifications and Licensures
- Required Medical Board License
Education
- Doctorate's Medical Doctor OR
- Doctorate's Osteopathic Medicine
Experience
- Required: 5years Clinical Related
- Required: 1 year Education
Specific Skills
- Quality Improvement
- Written and verbal communication skills
- Customer service skills
- Presentation skills
- Written and verbal communication skills
- Organizational skills
- Analytical Skills
- Interpersonal skills
- Multi-tasking skills
- Computer skills appropriate to position
- Collaborate and work with a team
