Regional Physician Advisor Position Near the Metropolitan Northern Virginia Area
4 weeks ago
City/State
Norfolk, VA
Overview
Work Shift
First (Days) (United States of America)
Serving Blue Ridge/Northern Virginia region
Job Summary
The Regional Physician Advisor conducts timely clinical review on cases referred by the Clinical Revenue Cycle for third level review to meet federal and state utilization and quality regulatory requirements. Documents clinical rationale for recommendation decisions. Works with the Epic physician documentation workgroup to support documentation best practice. Facilitates peer to peer discussion with third party payers to facilitate denial management, discuss medical necessity, and ensure compliant documentation requirements by payer. Meets with hospital Integrated Care Management and health care team members to discuss selected cases for comprehensive documentation, status levels, suggestion for resource and service management, quality, and length of stay recommendations. Discusses case with attending physician for issuance of a hospital notice of non-coverage, and downgrade of inpatient status. Assists in facilitation of education of medical staff in accurate clinical documentation integrity, and regulatory requirement efforts in coordination with the Clinical Documentation Specialist, Recovery Audit and Clinical Appeals team, onsite and remote Physician Advisors, VP-Chief Medical Officers, HIM, and other clinical service line leaders.
Qualifications:
MD - Doctor of Medicine: Doctor Of Osteopathic Medicine (Required), MD - Doctor of Medicine (Required)
Doctor of Osteopathic Medicine (DO) - Alabama - Alabama, Doctor of Osteopathic Medicine (DO) - Alabama - Alabama, Doctor of Osteopathic Medicine (DO) - Arizona - Arizona, Doctor of Osteopathic Medicine (DO) - Arkansas - Arkansas, Doctor of Osteopathic Medicine (DO) - Certification - North Carolina, Doctor of Osteopathic Medicine (DO) - Certification - Other/National, Doctor of Osteopathic Medicine (DO) - Certification - Virginia, Doctor of Osteopathic Medicine (DO) - Colorado - Colorado, Doctor of Osteopathic Medicine (DO) - Delaware - Delaware, Doctor of Osteopathic Medicine (DO) - Florida - Florida, Doctor of Osteopathic Medicine (DO) - Georgia - Georgia, Doctor of Osteopathic Medicine (DO) - Idaho - Idaho, Doctor of Osteopathic Medicine (DO) - Indiana - Indiana, Doctor of Osteopathic Medicine (DO) - Iowa - Iowa, Doctor of Osteopathic Medicine (DO) - Kansas - Kansas, Doctor of Osteopathic Medicine (DO) - Kentucky - Kentucky, Doctor of Osteopathic Medicine (DO) - Louisiana - Louisiana, Doctor of Osteopathic Medicine (DO) - Maine - Maine, Doctor of Osteopathic Medicine (DO) - Maryland - Maryland, Doctor of Osteopathic Medicine (DO) - Mississippi - Mississippi, Doctor of Osteopathic Medicine (DO) - Missouri - Missouri, Doctor of Osteopathic Medicine (DO) - Montana - Montana, Doctor of Osteopathic Medicine (DO) - Nebraska - Nebraska, Doctor of Osteopathic Medicine (DO) - New Hampshire - New Hampshire, Doctor of Osteopathic Medicine (DO) - New Jersey - New Jersey {+ 45 more}
Clinical, Physician Advisory Experience
Skills
Active Learning, Active Learning, Active Listening, Communication, Complex Problem Solving, Coordination, Critical Thinking, Judgment and Decision Making, Leadership, Learning Strategies, Mathematics, Mgmt of Financial Resources, Mgmt of Material Resources, Mgmt of Staff Resources, Microsoft Excel, Microsoft Word, Monitoring, Persuasion, Project Management, Quality Control Analysis, Reading Comprehension, Science, Service Orientation, Social Perceptiveness, Speaking {+ 5 more}
Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.
In support of our mission "to improve health every day," this is a tobacco-free environment.
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