Medical Director
5 days ago
Job Summary:
The Physician Advisor-Care Management and Clinical Documentation Improvement role is a full-time administrative physician position serving Good Shepherd Hospital and its affiliates. The successful candidate will work in collaboration with the Care Management Department and the medical staff to promote effective and efficient physician documentation, ensuring accurate Level of Care (LOC) designation and billing status.
Key Responsibilities:
- Lead the Utilization Review Committee in collaboration with the Director of Care Management.
- Participate in daily Interdisciplinary Rounds (IDRs) to expedite testing and treatment, promoting efficient patient care and appropriate LOC.
- Provide education to physicians and other clinicians on regulatory requirements, appropriate billing status, and utilization of alternate levels of care.
- Facilitate referrals to the continuum of care and mentor physicians regarding payer requirements.
- Collaborate with the Director of Care Management to monitor key metrics for Utilization Management and participate in action steps to achieve targets.
Requirements:
- Licensed physician in the state of residence.
- Certified by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP) - preferred.
- Experienced in clinical practice with understanding of utilization review.
- Served on or chaired a Utilization Management committee.
- Demonstrated cost-efficient practice.
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