What are the responsibilities and job description for the Physician Advisor position at Southeastern Health?
Position Purpose / Summary
Purpose : Provides physician leadership and expertise related to care coordination, length of stay (LOS) / Ievel of care (LOC) management, care variation management, patient flow / throughput management, ancillary service utilization (e.g., lab and radiology) and clinical documentation improvement (COl)
Policy-Setting Responsibilities : Responsible for reviewing and providing physician perspective for policies that relate to care coordination, care progression, patient access, care variation management and COl
Decision-Making Authority : Responsible for collaborating with the care coordination, nursing, patient access, ancillary services and COl departments to meet established goals and for leading physician participation and compliance with responsibilities
Supervisory Responsibility : Responsible for engaging physicians in care coordination, care progression, patient access, care variation management and COl activities
Applicant Skills / Background
1. Minimum Educational Training Required :
Graduate of an accredited medical school
Completion of specialty residency (e.g., Internal Medicine, Emergency Medicine)
2. Experience :
Five years recent experience in clinical practice in a hospital strongly preferred
Two years administrative background as physician manager preferred
Previous experience as a physician advisor preferred
Experience leading large-scale change efforts preferred
Experience in academic medicine, if applicable
3. License, Registration or Certification Required :
Board Certified / Eligible Physician licensed in the applicable states
Certification by American Board of Quality Assurance
Utilization Review Physicians (ABQAURP) preferred
4. Knowledge, Skills and Abilities :
Strong clinical acumen
Knowledge of case management principles, processes, and their practical application preferred
Working knowledge of third-party payor guidelines / medical necessity criteria (e.g. , knowledge of admission criteria for all levels of care)
Experience with denials management
Knowledge of clinical, quality, and administrative facets of the healthcare industry
Familiarity with clinical documentation requirements
Working knowledge of Centers for Medicare and Medicaid Services rules and regulations, and interest in building this knowledge through experience and partnership with Case Management
Excellent communication and presentation skills (both written and oral)
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