PHYSICIAN ADVISOR

This is a great opportunity for a Physician with Utilization Management experience who wants to practice as a Physician Advisor.

In this role, you will work with our Care Management team and Medical staff to ensure we are meeting Suburban Hospital's objectives for assuring quality patient care and effective and efficient utilization of health care services.

JOB SUMMARY:

• The Physician Advisory (PA) conducts clinical reviews on cases referred by care management staff and/or other health care professionals to meet regulatory requirements and in accordance with the hospitals objectives for assuring quality patient care and effective, efficient utilization of health care services.
• The PA meets with care management and health care team members to discuss selected cases and make recommendations for care, interacting with medical staff members and medical directors of third-party payers to discuss the needs of patients and alternative levels of care.
• The PA acts as consultant to and resource for attending physicians regarding their decisions relative to appropriateness of hospitalization, continued stay, and use of resources. The PA further acts as a resource for the medical staff regarding federal and state utilization and quality regulations.
• As the CDI physician advisor, the PA will act as a liaison between the CDI professional, HIM, and the hospital’s medical staff to facilitate accurate and complete documentation for coding and abstracting of clinical data, capture of severity, acuity and risk of mortality, in addition to DRG assignment.
• The PA will optimize utilization of patient observation statuses.

Qualifications:

• Minimum of 5 years' recent experience in clinical practice (as a M.D.) is preferred
• Utilization management experience as a member of the UM oversight committee or past Physician Advisor experience is preferred
• Able to obtain an unrestricted license as a physician in Maryland

This is a full-time exempt/salary position

Together we will deliver the Promise of Medicine!

Johns Hopkins Health System and its affiliates are drug-free workplace employers