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Medical Director

2 months ago

Irving, Texas, United States Christus Health Full time
Job Summary

The Physician Advisor - Clinical Utilization Specialist will serve as a key member of the Care Management team at Christus Health, providing expert guidance and support to physicians and clinical staff on matters related to clinical utilization, documentation, and care management.

Key Responsibilities
  • Lead the Utilization Review Committee in collaboration with the Director of Care Management, monitoring key metrics and participating in action steps to achieve targets.
  • Provide education to physicians and other clinicians on regulatory requirements, appropriate billing status, and utilization of alternate levels of care.
  • Work with physicians to facilitate referrals to the continuum of care and provide mentoring/coaching to UR Case Managers to increase knowledge in care progression.
  • 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 level of care.
  • Document patient care reviews, decisions, and other pertinent information per hospital policy.
  • Possess foundational knowledge of InterQual and MCG criteria and participate in Care Management Leadership & staff meetings to help identify and progress toward departmental goals.
Requirements
  • 5 years of clinical experience
  • Licensed physician in state of residence
  • Board certified in a clinical specialty
  • Certified by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP) - preferred
  • Experienced in clinical practice with an understanding of utilization review
  • Served on or chaired an Utilization Management Committee
  • Demonstrated cost-efficient practice
Highlights
  • Balanced professional and personal lifestyle
  • Competitive compensation and benefits
  • Relocation assistance
Community
  • Easy drive to major metropolitan areas
  • Easy access to local airport
  • Year-round outdoor activities
  • Excellent public and private schools