Physician Leadership Opportunity in Utilization Management
3 weeks ago
We are seeking a highly skilled Physician Advisor to join our team at CHRISTUS Health. As a key member of our Care Management Department, you will play a critical role in shaping the future of healthcare delivery.
Job SummaryThe Physician Advisor is responsible for serving as a liaison between the medical staff and the Care Management Department, providing guidance on physician practice patterns, documentation, and utilization of resources. This role requires strong clinical knowledge, excellent communication skills, and the ability to work collaboratively with interdisciplinary teams.
Responsibilities- Lead the Utilization Review Committee in collaboration with the Director of CM to develop and implement utilization management plans.
- Monitor key metrics for UM and participate in action steps to achieve targets, including denial trends, appeals, recoveries, length of stay, and condition code 44.
- Provide education to physicians and other clinicians on regulatory requirements, billing status, and utilization of alternate levels of care.
- Facilitate referrals to the continuum of care and educate physicians on the benefits and importance of a clinical documentation program.
- Participate in daily IDRs, provide guidance to the Emergency Department Physicians and CM staff on correct LOC designation, and act as a liaison with payers to facilitate approvals and prevent denials or carved-out days.
- 5 years of clinical experience
- Licensed physician in state of residence
- Board certified in a clinical specialty
- Preferred certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP)
- Experience in clinical practice with an understanding of utilization review
- Served on or chaired an Utilization Management Committee
We offer a competitive compensation package, including a salary range of $250,000 - $350,000 per year, depending on experience, plus benefits and relocation assistance. Our team values work-life balance and provides opportunities for professional growth and development. Located near New Orleans and Baton Rouge, our community offers easy access to outdoor activities, cultural events, and a diverse range of educational institutions.
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