Higher Standards, Better Results
Physician Advisor
Location
New Jersey
Posted
7 days ago
Salary
0
Seniority
Senior
Job Description
Physician Advisor
Med-Metrix
• Performs case reviews of all case types in a knowledgeable and conscientious manner to achieve the highest degree of compliance • Works closely with the Client's medical staff leadership, the entire medical staff, including resident physician house staff • Identifies opportunities to optimize length of hospital stay and efficient management of resources • Ensures patients are in the appropriate level of care, supporting documentation, coding improvements and compliance • Responds to requests for assistance on clinical reviews for medical necessity • Provides consultation to attendings, nurses, and case management staff regarding complex clinical issues • Applies professional judgment and patient specific variables as may be necessary or justifiable • Maintains accountability for achieving case management outcomes • Describes ways to provide improved health record documentation that specifically affect ICD code assignment capture of severity, acuity, risk of mortality, and DRG assignment • Participates in ongoing training and education related to the Physician Advisor role • Meets productivity and quality standards within established time requirements • Achieves performance goals as outlined in employment agreement • Maintains confidentiality of patient care and business matters • Demonstrates behavior that supports the organization's mission • Facilitates, mentors, and educates other physicians regarding payer requirements • Attends all meetings as requested by PAOC leadership • Participates in the peer review process as may be necessary or requested • Maintains medical licensure and board certification in good standing • Commits full attention to Physician Advisory and execution of outlined tasks • Other duties as assigned
Job Requirements
- Board Certified and licensed to practice medicine in the US or 3+ years active clinical experience in the US
- 3+ years working as a Physician Advisor performing Level of care reviews as well as Peer to Peer Reviews
- Basic technical skills with Hospital EMRs a must
- Hold and maintain an unrestricted medical license and Board Certification
- Possess or acquires a solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety
- Possess a working knowledge of (Hospital) organization & case management operations and administrative standards and policies
- Familiarity with MCG/InterQual placement status criteria is 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
- Physician Advisor Sub-Specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred
- Able to effectively present information, both formal and informal
- Strong analytical skills
- Proficiency in Microsoft Office Suite
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
Benefits
- Confidentiality of patient care and business matters
- Required orientation and training related to the Physician Advisor role
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