Physician Advisor

Job Summary and Responsibilities

1. The Physician Advisor serves the Hospital through collaborating with, advising, and teaching the Care Coordination Department; serving as a member of the medical staff; and coordinating with Hospital leadership on matters regarding progression of patient care, medical necessity, compliance with regulatory guidelines, payer relationships; clinical documentation integrity, and identification of trends in the over and under-utilization of resources.

2. The Physician Advisor should be a key member of the medical staff and take on the role as leader of the Hospital's utilization review / management committee, which is charged with adhering to regulatory requirements while ensuring high levels of healthcare quality and acceptable levels for the cost of care.

3. The Physician Advisor will conduct clinical reviews on cases referred by case / utilization management and / or other healthcare professionals in accordance with Hospital objectives related to quality care of patients, regulatory compliance, and utilization management (including LOS).

4. The Physician Advisor should discuss his / her role with the Hospital CMO, or similar position, to clearly define expectations and mentorship opportunities. Specifically, the Physician Advisor will be expected to work in close partnership with CommonSpirit Healths Internal Physician Advisor Services (IPAS) to ensure continuity of services provided.

5. Additionally, the Physician Advisor will be expected to understand and appreciate the unique elements of a Hospitals culture, history, and place in the community it serves. All work should be aligned with CommonSpirit Healths Mission, Vision, and Values.

6. Because of the importance of the role of the Physician Advisor and the visibility this role brings, it is expected that the Physician Advisor has a minimum of 5-7 years of leadership experience (or equivalent experience) in inpatient and / or advisory settings and possess the appropriate credentials in good standing.

Key Responsibilities

ESSENTIAL JOB FUNCTIONS :

CLINICAL EFFECTIVENESS :

• ? Lead in clinical process design / improvement sessions
• ? Collaborate with stakeholders in the development of a compliant and efficient Care Delivery Model (CDM) VMMC
• ? Provide clinical expertise related to medical necessity claims Job Title : Physician Advisor Job Code : Dept :
• ? Collaborate on the development and implementation of standard Clinical Care Pathways for defined diagnoses and DRGs
• ? Review issues identified by Care Coordination to ensure appropriate follow-up, recommends improvement initiatives as needed and makes suggestions to providers and appropriate department chairs as necessary
• ? Provide consultation to Care Coordination staff regarding complex clinical issues and advises on next steps
• ? Documents patient care reviews, decisions, and other pertinent information per Hospital / Utilization Management policy

COLLABORATION :

UTILIZATION MANAGEMENT :

PHYSICIAN LIAISON :

CLINICAL DOCUMENTATION INTEGRITY (CDI) :

Competing Interests / Exclusions :

Because the Physician Advisor in this position will have access to extraordinarily sensitive and confidential information of the Hospital, it is understood that the Physician Advisor may not during his or her term in this position take on the following roles outside the CommonSpirit Health system :

Job Requirements

Where You'll Work

Virginia Mason Franciscan Health has a rich history of providing exceptional healthcare, dating back to 1891. Building upon a legacy of compassionate care and innovation, our organization has evolved over the years through strategic partnerships and integrations to expand our reach and services across the Puget Sound area.

Today, as Virginia Mason Franciscan Health, we remain deeply committed to healing the whole person - body, mind, and spirit - in the communities we serve. This commitment is strengthened by the diverse expertise and shared values brought together through our growth.

Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex disease management, all grounded in rigorous research and education. Our comprehensive network of 10 hospitals and nearly 300 care sites strategically located across the greater Puget Sound region reflects our ongoing commitment to accessibility and comprehensive care.

We are proud of our pioneering medical advances and numerous awards and accreditations that reflect our dedication to excellence. When you join Virginia Mason Franciscan Health, you become part of a team that delivers top-quality, professional healthcare in modern, well-equipped facilities, and contributes to a legacy of service built on collaboration and shared purpose.

Pay Range

$120.19 - $168.27 / hour