Anesthesiology Physician

Description

Roles and Responsibilities Overview

The Physician Advisor is a full-time administrative physician role serving CHRISTUS St. Michael hospital and its affiliates through teaching, consulting, and advising both the Care Management Department and the medical staff on matters regarding physician practice patterns, documentation, over- and under-utilization of resources, medical necessity, compliance rules and regulations, collaboration and relationships with payers, and the community. The PA also ensures physician support and execution for the Care Management and CDI Departments' initiatives by promoting effective and efficient physician documentation to support the patient's Level of Care (LOC), billing status, and appropriateness of Medicare Severity-Diagnosis Related Group (MS-DRG) / DRG assignment. The PA will submit monthly time records documenting time actually spent in the provision of the responsibilities outlined below. M-F, no call responsibilities!

Reporting Relationship

The PA reports directly to the Chief Medical Officer of St. Michael hospital- Texarkana

Professional Qualifications

The Physician Advisor-Care Management and Clinical Documentation Improvement role should be staffed by a physician with the following qualifications :

5 years of clinical experience

Licensed physician in state of residence

Board certified in a clinical specialty

Certified by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP) - preferred

Experienced in clinical practice with an understanding of utilization review

Served on or chaired an Utilization Management Committee

Demonstrated cost-efficient practice

Physician Advisor - Care Management & CDI Duties and Responsibilities

Utilization Management Plan : 20%

• In collaboration with the Director of CM, lead the Utilization Review Committee
• Conduct secondary status reviews for appropriate level of care determination
• Conduct peer-to-peer consults with the payor medical directors for the denied cases, to resolve medical necessity issues prior to claims submission.
• In collaboration with the CMO and Director of CM, monitor key metrics for UM and participate in action steps to achieve targets. Metrics include (but not limited to) :
• Denial trends, appeals & recoveries
• Length of stay- inpatient and observation
• Condition Code 44

Physician & Staff Education : 15%

Care Management : 50%

Clinical Documentation Integrity 15%

Highlights / Benefits :

Balanced professional and personal lifestyle

Competitive compensation and benefits

No state income tax

Relocation assistance

Community Description :

Easy drive to Dallas

Enjoy the lush green countryside, pine tree-covered hills and lakes.

Year-round outdoor activities include golfing, hunting, fishing, camping, hiking, and boating.

Excellent public and private schools

Recruiter Contact Information :

Recruiter Contact Information :

Liz Flippo

Email :

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