Physician Advisor

3 weeks ago


Prescott, Arizona, United States Unavailable Full time
Overview

Dignity Health-Yavapai Regional Medical Center is a leading healthcare provider in Prescott, Arizona, offering a comprehensive range of inpatient and outpatient services. As a not-for-profit integrated healthcare provider, we are committed to delivering exceptional patient care and promoting a culture of compassion and excellence.

Responsibilities

The Physician Advisor plays a critical role in promoting evidence-based standards of medical care while maintaining appropriate utilization of hospital resources. Key responsibilities include:

  • Mitigating denials for payment from insurance payers by providing valid and effective secondary medical necessity reviews.
  • Reviewing and reporting performance measures and making recommendations to departments and the Medical Executive Committee regarding opportunities for improvement of patient care, resource utilization, billing compliance, and reduction of claims denials.
  • Providing compliance elements for Centers for Medicare and Medicaid Services (CMS) Conditions of Participation by performing secondary medical necessity reviews.
  • Championing good stewardship of resources and optimizing revenue capture by providing oversight for appropriate status determinations.
  • Optimizing cost of care by providing oversight for appropriate levels of care determinations and serving as a resource for Care Coordination.
Qualifications

To be successful in this role, you will need:

  • A minimum of five years of clinical practice experience.
  • An active membership in good standing of the hospital's medical staff and participation in various medical committees.
  • A Doctor of Medicine (MD or DO) degree and licensure to practice medicine without restrictions in the State of Arizona.
  • Strong clinical judgment and technical abilities, as well as excellent interpersonal and communication skills.
Benefits

We offer a comprehensive benefits package, including medical, dental, and vision insurance, flexible spending accounts, a matching 403(b) retirement program, and a fully funded pension plan. Additionally, we offer paid time off, tuition reimbursement, mental health benefits, and employee life insurance. Eligible employees may also receive annual incentive pay based on company performance and relocation assistance if applicable.


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