Physician Advisor
4 weeks ago
Job Summary:
The Physician Advisor - Care Management Specialist will serve CHRISTUS St. Frances Cabrini Hospital and its affiliates 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.
Key Responsibilities:
- Participate in daily IDRs to expedite testing and treatment, promoting efficient patient care and appropriate Level of Care (LOC)
- 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-coverage determination, discussing the case with the attending physician and the process for issuance and appeal
Requirements:
- 5 years of clinical experience
- Licensed physician in the state of residence
- Board certified in a clinical specialty
- Preferred: Certified by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP)
Benefits:
- Competitive compensation and benefits
- Relocation assistance
About CHRISTUS Health:
CHRISTUS Health is a Catholic health system committed to delivering high-quality, compassionate care to all people, regardless of their background or financial situation.
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