Physician Advisor

3 days ago


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

The Physician Advisor is a key member of the Care Management team at Christus Health, responsible for providing clinical expertise and guidance to ensure optimal patient care and resource utilization. This full-time administrative physician role will work closely with the Care Management Department and medical staff to promote effective and efficient physician documentation, collaboration, and relationships with payers.

Responsibilities
  • Participate in daily IDRs to expedite testing and treatment, promoting efficient patient care and appropriate Level of Care (LOC) designation.
  • Provide guidance and assistance to Emergency Department Physicians and Care Management staff to ensure correct LOC designation at intake.
  • Act as a liaison with payers to facilitate approvals and prevent denials or carved-out days when appropriate.
  • Review cases indicating a need for issuance of a hospital notice of non-covered determination, discussing the case with the attending physician and facilitating the process for issuance and appeal.
  • Document patient care reviews, decisions, and other pertinent information per hospital policy.
  • Possess foundational knowledge of InterQual and MCG criteria.
  • Participate in Care Management Leadership and 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, assisting with identifying a physician to review such record.
Requirements
  • 5 years of clinical experience.
  • Licensed physician in the 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 and Benefits
  • Balanced professional and personal lifestyle.
  • Competitive compensation and benefits.
  • Relocation assistance.
Community Description

Christus Health is located in a scenic area with easy access to New Orleans and Baton Rouge. The community offers a range of outdoor activities, including golfing, hunting, fishing, camping, hiking, and boating. Excellent public and private schools are also available.


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