Physician Care Advisor Lead

6 days ago


Prescott, Arizona, United States Dignity Health Full time
About Us

Dignity Health-Yavapai Regional Medical Center (DH-YRMC) is a leading healthcare provider that offers a comprehensive range of inpatient and outpatient services. Our healing network includes two full-service acute care hospitals, outpatient service centers, and primary and specialty care clinics.

Our Mission

We are committed to delivering exceptional patient care while promoting healthy lifestyles and wellness. Our compassionate and skilled team of caregivers work together to provide personalized care that addresses the unique needs of each patient.

Career Opportunities

We invite talented professionals like you to join our team at DH-YRMC. As a Physician Care Advisor Lead, you will play a critical role in promoting evidence-based standards of medical care and ensuring appropriate utilization of hospital resources.

Job Description

The Physician Care Advisor Lead reports to our Chief Medical Officer (CMO) and works closely with the Department of Care Coordination, Medical Staff, Nursing Staff, and Administration to facilitate communication and collaboration regarding systems-based practice, regulatory and quality considerations in the delivery of medical care.

Responsibilities
  • Mitigate denials for payment from insurance payers by providing valid and effective secondary medical necessity reviews.
  • Review and report performance measures and make recommendations to Departments and the Medical Executive Committee regarding opportunities for improvement of patient care, resource utilization, billing compliance, and reduction of claims denials.
  • Provide compliance element for Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (COP) by performing secondary medical necessity reviews.
  • Champion good stewardship of resources.
Requirements
  • Minimum of five years clinical practice experience.
  • Active member in good standing of Hospital's medical staff and participating member of various medical committees.
Benefits

We offer a comprehensive benefits package that includes:

  • Medical/Dental/Vision Insurance (no premium option for employee benefits)
  • Flexible spending accounts
  • Matching 403(b) retirement program
  • Fully Funded Pension Plan
  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Mental Health Benefit
  • Employee Life Insurance
  • Eligible for annual incentive pay based on company performance
  • Relocation assistance if applicable
Salary Range

$76.92 - $123.07 per hour.


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