Physician Advisor
4 weeks ago
This is a full-time administrative physician position serving CHRISTUS Health through teaching, consulting, and advising on matters regarding physician practice patterns, documentation, over- and under-utilization of resources, medical necessity, compliance rules and regulations, collaboration and relationships with payers, and the community.
The Physician Advisor will ensure physician support and execution for the Care Management and CDI Departments' initiatives by promoting effective and efficient physician documentation to support the patient's Level of Care (LOC), billing status, and appropriateness of Medicare Severity-Diagnosis Related Group (MS-DRG)/DRG assignment.
This position will be in Alexandria, Louisiana.
Responsibilities:
- Participate in daily IDRs to expedite testing and treatment to promote efficient patient care and appropriate LOC
- Provide guidance/assistance to the Emergency Department Physicians and CM 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 that indicate a need for issuance of a hospital notice of non-coverage determination
- Document patient care reviews, decisions, and other pertinent information per hospital policy
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
Highlights:
- Balanced professional and personal lifestyle
- Competitive compensation and benefits
- Relocation assistance
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