Administrative/CEO Physician

4 days ago

Sarasota FL United States First Physicians Group of Sarasota Memorial Health Care System Full time

Sarasota Memorial Health Care System is seeking to employ a Physician Advisor to join its growing Physician Advisor Program.

The system's flagship 897-bed campus, Sarasota Memorial Hospital-Sarasota, is consistently recognized for its delivery of quality care and best patient experience in the nation.

* CMS 5-Star rated hospital for overall quality. The only hospital in Florida and one of just 17 hospitals in the U.S. to earn the five-star rating in every reporting period since the program s inception in 2016.
* Earned straight A Grades for Patient Safety from Leapfrog since 2016.
* Recognized in U.S. News 50 "Best Hospitals" list in .
* Named among the World s Best Hospitals for a 6 th year in a row by Newsweek, 2024.
* Forbes list of America s Best Large Employers for 2024 and the No. 1 healthcare employer in Florida in 2023.
* Earned consistent Magnet Nursing Recognition from the American Nurses Credentialing Center (ANCC) since 2003. Sarasota Memorial has remained the only hospital in the region with Magnet recognition for the past 20 years.

Job Summary
This dynamic, on-site, Physician Advisor (PA) provides 1) physician administrative support and leadership to the utilization and resource management areas of Integrated Case Management including mentoring/coaching Care Coordinators, Utilization Review staff, and Social Workers, 2) reviewing cases for medical necessity, 3) daily multi-disciplinary rounds, 4) collaborating with Medical Staff, advanced practice practitioners and house staff in determining level of care, medical necessity, providing education and feed-back on documentation improvement opportunities 5) participating in third-party payor denial, appeal, and peer-to-peer processes. The physician advisor will also identify and address standards of best practice related to throughput, efficiency, length of stay, resource utilization, high quality admissions, readmission avoidance, and transitions of care across the continuum. The physician advisor will act as a member of the Utilization Review Committee and serve as a liaison to Clinical Systems to support best practice care management. The physician advisor will consider compliance with regulatory and payor requirements, policy and organizational goals, and quality patient outcomes when performing patient reviews. Additionally, a small (0.2FTE) active clinical practice is desired in the hospital setting.
Required Qualifications:

* MD or DO from an accredited school of medicine
* Current Board Certification in a primary specialty
* Active Florida medical license or meet qualifications to obtain a Florida license
* Qualified as a provider under Medicare and Medicaid
* Current medical staff privileges or active hospital experience in the last 2 years, which is required for Credentialing at SMHCS
* A minimum of 5 years of acute hospital care experience with exposure to utilization management, case management, care coordination, and documentation initiatives
* A minimum of 1 year of leadership experience
* Maintains current knowledge of federal, state, and payor regulatory and contract requirements
* Demonstrated teamwork, performance analysis, presentation, facilitation, planning, and communication skills.
* Ability to maintain a positive rapport with hospital and departmental leadership, case management staff, and physicians
* Ability to work with team members in managing and developing medical utilization programs and documentation initiatives

Preferred Qualifications:

* Internal Medicine or sub-specialty in Internal Medicine, Family Medicine, Emergency Medicine

* Previous experience with case management, clinical documentation integrity, or Utilization Management
* Experience in managed care contracting and familiarity with Medicare and managed care reimbursement policies

Preferred License and Certifications:

* ABQAURP (American Board of Quality Assurance and Utilization Review Physicians), with a physician advisor sub-specialty
* ACPA (American College of Physician Advisors Certification)

Please contact Joelle Hennesey, Director, Physician & APP Recruitment, at or for more information.

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