What are the responsibilities and job description for the Medical Director/Physician Advisor UM position at Texas Health Huguley FWS?

Job Description - Medical Director / Physician Advisor UM (25005267)

Job Number :

Medical Director / Physician Advisor UM (25005267)

All the benefits and perks you need for you and your family :

Paid Days Off from Day One
Student Loan Repayment Program
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support

Our promise to you : Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule : Full Time

Shift : Days

The community you’ll be caring for :

AdventHealth Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment, and research.

Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery.

Building a brand new, six-story surgical and patient care tower which will ensure state-of-the-art medical and surgical care for generations to come.

Awarded the Get With The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association / American Stroke Association and recognized as a recipient of their Target : Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.

The role you’ll contribute :

The Physician Advisor provides primary support for Utilization Management (UM) and secondary support for Care Management (CM) departments and serves as a liaison between UM and CM teams and medical staff, as well as, the medical liaison for payor escalations. The Physician Advisor is responsible for educating, informing, and advising members of the Utilization Management, Care Management, Managed Care and Revenue Cycle departments and applicable medical staff, as well as collaborating with other disciplines to assist in the improvement of clinical documentation, patient safety, and quality outcomes.

Through primary support of Utilization Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient care / observation stays, and referral services. The Physician Advisor is an important contact for clinicians, external providers, contracted health insurance payors, and regulatory agencies. This individual also serves as the subject matter expert, providing clinical expertise and business direction in support of medical management programs, promoting the delivery of high quality, patient-focused and cost-effective medical care.

The value you’ll bring to the team :

Provides clinical support / validation for both Utilization Management and Care Management teams.

Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care Management structures, functions, and use of clinical guidelines.

Develops and facilitates productive internal / external relationships with all physicians and constituents of Utilization Management and Care Management.

Provides suggested approaches to clarifying clinical questions when Utilization Management and Care Management staff interact with physicians, nurses, or other health professionals.

Maintains a positive and supportive relationship between the inpatient facilities, payors, and physicians (hospitalist groups and primary care providers), and acts as the interdepartmental liaison for ACO activities and program development.

Provides guidance to clinical questions from Utilization Management staff involved in authorizations, concurrent review, and denials.

The expertise and experiences you’ll need to succeed :

Graduate of accredited Medical School.

Bachelor of Science.

Minimum of 5 years of experience in hospital medicine in acute care setting.

Current and valid license as a physician.

Board certified and eligible for membership on the Hospital medical staff.

Job : Case Management

Organization : AdventHealth Tampa

Primary Location : Work Locations :

TP AH TAMPA VIRTUAL VIRTUAL Tampa 33613

Operating Unit : AdventHealth West Fl Division

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