Physician - Advisor (Care Management and CDI)
3 weeks ago
Description
Roles and Responsibilities Overview
The Physician Advisor-Care Management and Clinical Documentation Improvement (PACM) is a full-time administrative physician role serving Good Shepherd Hospital - Longview 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 PACM 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 PACM will submit monthly time records documenting time actually spent in the provision of the responsibilities outlined below.
Professional Qualifications
The Physician Advisor-Care Management and Clinical Documentation Improvement role should be staffed by a physician with the following qualifications:
Licensed physician in state of residence
Certified by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP) - preferred
Experienced in clinical practice with understanding of utilization review
Served on or chaired a 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
In collaboration with the 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%
Provide education to physicians and other clinicians related to regulatory requirements, appropriate billing status and utilization of alternate levels of care, community resources, and end of life care.
Work with physicians to facilitate referrals to the continuum of care
Facilitate, mentor, and educate other physicians regarding payer requirements
Provide mentoring/coaching to UR Case Managers to increase knowledge in care progression
Educate physicians on the benefits and importance of a clinical documentation program and how to work with CDI specialists
Care Management: 50%
Participate in daily IDRs takes action to expedite testing and treatment to promote efficient patient care and appropriate LOC
Provides guidance/assistance to the Emergency Department Physicians and CM staff to assure correct LOC designation at intake
Act as a liaison with payers to facilitate approvals and prevent denials or carved out days when appropriate
Participate in review of long stay patients escalated from Care Management to facilitate the use of the most appropriate LOC
Review cases that indicate a need for issuance of a hospital notice of non-coverage determination. Discuss the case with the attending physician and if additional clinical information is not available, discuss the process for issuance and appeal with the physician.
Document patient care reviews, decisions, and other pertinent information per hospital policy
Possess foundational knowledge of InterQuale criteria
Participate in Care Management Leadership & staff meetings to help identify and progress toward departmental goals
Notify the Care Manager of any conflict of interest in reviewing a particular patient record. Assist with identifying a physician to review such record.
Clinical Documentation Integrity 15%
Provide feedback to physicians in each service on clinical documentation using specific case examples/3M
Recruiter Contact Information:
Lorie Seals
Email:
lorie.seals@christushealth.org
-
Physician - Physician Advisor
Found in: beBee S US - 3 weeks ago
Longview, United States CHRISTUS Health Full timeDescriptionCHRISTUS Good Shepherd Medical Center-Longview is a full service, acute-care, 425-bed regional referral center, considered one of the regions top Level III Trauma Center.The Physician Advisor reports to the Chief Medical Officer and serves as a resource to the utilization review and care management staff on medical necessity, level of care,...
-
Physician - Physician Advisor
Found in: beBee jobs US - 2 weeks ago
Longview, Texas, United States CHRISTUS Health Full timeCHRISTUS Good Shepherd Medical Center-Longview is a full service, acute-care, 425-bed regional referral center, considered one of the regions top Level III Trauma Center.The Physician Advisor reports to the Chief Medical Officer and serves as a resource to the utilization review and care management staff on medical necessity, level of care, patient care...
-
Longview, United States Christus Physician Group Full timeDescription Summary: CHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking an ENT Physician to join an established practice in Longview. Enjoy a balanced professional and personal lifestyle that includes: Malpractice Insurance Excellent work/life balance Competitive compensation and benefits package Epic EMR CHRISTUS...
-
Longview, United States Christus Physician Group Full timeDescription CHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking a Non-Invasive Cardiologist Physician to join an established practice in Longview. The ideal candidate would have advanced imaging techniques, including cardiac CT and MRI. CHRISTUS Good Shepherd Medical Center Longview, TX Platinum Performance...
-
Physician / ObGyn / Texas / Locum or Permanent / Physician -OB/GYN Job
Found in: Lensa US P 2 C2 - 2 weeks ago
Longview, United States Christus Physician Group Full timeDescriptionCHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking an OB/GYN physician to join an established practice in Longview. Work alongside four other physicians in a state of the art practice to provide quality outpatient care. Additionally, provide outstanding inpatient care with CHRISTUS Good Shepherd...
-
Longview, United States Christus Physician Group Full timeDescription CHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking a Pulmonologistto join an established practice in Longview. CHRISTUS Good Shepherd Medical Center in Longview, TX A full service, acute-care, 425-bed regional referral center. As one of the regions top Level III Trauma Center and, it serves a vital role...
-
Longview, United States Christus Physician Group Full timeDescription CHRISTUS Good Shepherd Medical Center- Longview is seeking a Board Certified/Board Eligible outpatient neurologist to help build a newly established service line in the community. The physician will be seeing patients in an outpatient clinic with no inpatient responsibilities. Additionally, the physician will work alongside a dedicated...
-
Physician / Neurology / Texas / Locum or Permanent / Physician - Outpatient Neurology Job
Found in: Lensa US P 2 C2 - 2 weeks ago
Longview, United States Christus Physician Group Full timeDescriptionCHRISTUS Good Shepherd Medical Center- Longview is seeking a Board Certified/Board Eligible outpatient neurologist to help build a newly established service line in the community. The physician will be seeing patients in an outpatient clinic with no inpatient responsibilities. Additionally, the physician will work alongside a dedicated...
-
Physician - Critical Care
Found in: beBee S US - 2 weeks ago
Longview, United States CHRISTUS Health Full timeDescriptionBe a part of the nation's premier physician group by joining our Critical Care Nocturnist team in Longview, TX.CHRISTUS Trinity Clinic:The areas preferred multi-specialty medical groupOver 700 physicians and advance practice providers representing 41 specialties in 82 clinic locations throughout Northeast TexasA physician led group with its own...
-
Physician - Critical Care
Found in: beBee jobs US - 2 weeks ago
Longview, Texas, United States CHRISTUS Health Full timeBe a part of the nation's premier physician group by joining our Critical Care Nocturnist team in Longview, TX.CHRISTUS Trinity Clinic:The areas preferred multi-specialty medical groupOver 700 physicians and advance practice providers representing 41 specialties in 82 clinic locations throughout Northeast TexasA physician led group with its own board of...
-
Physician - Critical Care
Found in: beBee S US - 6 days ago
Longview, United States CHRISTUS Health Full timeDescriptionBe a part of the nation's premier physician group by joining our Critical Care team in Longview, TX. Rotate 7 on, 7 off, with 12 hour shifts on one campus with excellent colleagues. Responsibilities will include teaching Internal Medicine Residents.CHRISTUS Trinity Clinic:The areas preferred multi-specialty medical groupOver 700 physicians and...
-
Physician - Critical Care
2 weeks ago
Longview, United States Christus Health Full timeDescriptionBe a part of the nation's premier physician group by joining our Critical Care team in Longview, TX. Rotate 7 on, 7 off, with 12 hour shifts on one campus with excellent colleagues. Responsibilities will include teaching Internal Medicine Residents. CHRISTUS Trinity Clinic: The area’s preferred multi-specialty medical groupOver 700...
-
Physician - Pulmonary
Found in: Talent US C2 - 3 weeks ago
Longview, United States CTC Longview Cardiovascular and Thoracic Surgery Full timeJob Description CHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking a Pulmonologist to join an established practice in Longview. CHRISTUS Good Shepherd Medical Center in Longview, TX A full service, acute-care, 425-bed regional referral center. As one of the region’s top Level III Trauma Center and, it...
-
PhysSlry MTE Hospitalists GSMC Longview
Found in: beBee S US - 3 weeks ago
Longview, United States CHRISTUS Health Full timeDescriptionSummary:CHRISTUS Health is seeking a Hospitalist Assistant Medical Director to add to its established practice at CHRISTUS Good Shepherd Health System in Longview, TX. These are employed positions with a competitive salary, quality bonus, moving allowance, a comprehensive benefits package, and no state income tax. Assistant Medical Director will...
-
PhysSlry MTE Hospitalists GSMC Longview
Found in: beBee jobs US - 2 weeks ago
Longview, Texas, United States CHRISTUS Health Full timeSummary:CHRISTUS Health is seeking a Hospitalist Assistant Medical Director to add to its established practice at CHRISTUS Good Shepherd Health System in Longview, TX. These are employed positions with a competitive salary, quality bonus, moving allowance, a comprehensive benefits package, and no state income tax. Assistant Medical Director will report to...
-
Physician - Cardiology
Found in: beBee S US - 3 weeks ago
Longview, United States CHRISTUS Health Full timeDescriptionCHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking a Non-Invasive Cardiologist Physician to join an established practice in Longview. The ideal candidate would have advanced imaging techniques, including cardiac CT and MRI.CHRISTUS Good Shepherd Medical Center Longview, TXPlatinum Performance Achievement...
-
Pathology Physician
Found in: beBee jobs US - 3 days ago
Longview, Texas, United States AMN Healthcare Full timeJob Description & RequirementsPathology PhysicianStartDate: ASAP Pay Rate: $ $1151.95This facility is seeking a Pathology Physician for locum tenens support as they look to fill a current need.Details & requirements for this opportunity: Schedule: July 1 December 31, Monday Friday 8am 5pmJob Setting: hospitalTypes of Cases: 60% biopsies with many...
-
Physician - Cardiology
2 weeks ago
Longview, United States Christus Health Full timeDescriptionCHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking a Non-Invasive Cardiologist Physician to join an established practice in Longview. The ideal candidate would have advanced imaging techniques, including cardiac CT and MRI. CHRISTUS Good Shepherd Medical Center Longview, TX Platinum Performance...
-
Physician - ENT
Found in: beBee S US - 3 weeks ago
Longview, United States CHRISTUS Health Full timeDescriptionSummary:CHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking an ENT Physician to join an established practice in Longview.Enjoy a balanced professional and personal lifestyle that includes:Malpractice InsuranceExcellent work/life balanceCompetitive compensation and benefits packageEpic EMRCHRISTUS Trinity...
-
Physician - Endocrinology
Found in: beBee S US - 3 weeks ago
Longview, United States CHRISTUS Health Full timeDescriptionSummary:CHRISTUS Trinity Clinic, home to one of the largest multispecialty groups in Texas, is seeking an Endocrinologist Physician to join an established practice in Longview.Enjoy a balanced professional and personal lifestyle that includes:Malpractice InsuranceExcellent work/life balanceCompetitive compensation and benefits packageEpic...
