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Clinical Advisor
2 months ago
We are seeking a highly skilled Physician Advisor to join our team at Highmark Health. As a Physician Advisor, you will play a critical role in evaluating the medical necessity and appropriateness of patient care, working closely with our healthcare team to ensure the best possible outcomes.
Key Responsibilities- Evaluate Medical Necessity: Work with our healthcare team to evaluate the medical necessity and appropriateness of patient care, including admission to the hospital, utilization of observation status, and continued stay in the hospital.
- Provide Medical Expertise: Provide medical expertise, advice, and support to our Case Management Department, ensuring that patients receive the highest quality care.
- Collaborate with Healthcare Team: Collaborate with our healthcare team, including attending physicians, case managers, and other hospital personnel, to ensure seamless patient care.
- Develop and Implement Clinical Guidelines: Develop and implement clinical guidelines to ensure that patient care is aligned with best practices and industry standards.
- Participate in Quality Improvement Initiatives: Participate in quality improvement initiatives to identify areas for improvement and implement changes to enhance patient care.
- Doctorate in Medicine: Doctorate in Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree.
- Clinical Experience: 5 years of clinical practice experience in a hospital setting.
- Board Certification: Board eligible or board certified in a relevant medical specialty.
- PA License: PA license in good standing.
