Physician Advisor
Overview
The Physician Advisor is a key member of the healthcare organization's leadership team and is charged with meeting the organization's 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.
Requirements :
- Hold and maintain an unrestricted medical license in the state of Georgia.
- Meet the requirements (and become a member) of the Hospital medical staff.
- 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 Navicent & case management operations and administrative standards and policies.
- Strong computer skills and working knowledge of the EMR.
- 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.
- Ability to build rapport with medical staff and hospital leadership to obtain the buy-in and collaboration necessary to achieve desired outcomes.
Physician Advisor
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 an...
Physician Advisor
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 an...
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