Physician Advisor
6 days ago
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 regulatory compliance.
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.
- Facilitate referrals to the continuum of care and work with physicians to promote efficient patient care and appropriate Level of Care (LOC) designation.
- 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.
- 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.
- 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
- Balanced professional and personal lifestyle
- Competitive compensation and benefits
- Relocation assistance
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Clinical Utilization Advisor
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Irving, Texas, United States Christus Health Full timeOverview:The Clinical Utilization Advisor is a pivotal full-time administrative role at CHRISTUS Health, dedicated to enhancing patient care through strategic guidance and collaboration. This position involves educating, consulting, and advising both the Care Management Department and the medical staff on critical aspects such as physician practice patterns,...
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Clinical Advisor
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Physician Advisor
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Irving, Texas, United States CHRISTUS Health Full timeAbout the RoleThe Physician Advisor - Care Management & Clinical Documentation Improvement is a key member of the CHRISTUS Health team, responsible for providing clinical expertise and guidance to support the delivery of high-quality patient care. This role requires a strong understanding of clinical documentation, care management, and utilization review...
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Healthcare Advisor
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Clinical Advisor for Care Management
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Clinical Advisor for Care Management
1 week ago
Irving, Texas, United States Christus Health Full timeOverview:The Clinical Advisor is a pivotal full-time administrative role at Christus Health, focusing on guiding the Care Management Department and medical personnel. This position emphasizes education, consultation, and advisory services concerning physician practice patterns, documentation standards, resource utilization, medical necessity, compliance...
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Healthcare Utilization Specialist
1 week ago
Irving, Texas, United States Christus Health Full timePosition Overview:The Clinical Advisor plays a pivotal role in the administration of healthcare services at Christus Health, providing expertise in guiding both the Care Management Department and medical personnel. This position focuses on enhancing physician practice patterns, ensuring compliance with medical necessity, and optimizing resource utilization....
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Medical Director
6 days ago
Irving, Texas, United States Christus Health Full timeJob SummaryThe 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 ResponsibilitiesLead the Utilization Review Committee in...
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RN Utilization Review II
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