Hospitalist Physician Lead

5 hours ago


Prescott, Arizona, United States CommonSpirit Health Full time
About the Position

This newly created position emphasizes facilitating communication between departments regarding systems-based practice, regulatory and quality considerations in medical care delivery. The successful candidate will have a strong understanding of hospital operations, clinical guidelines, and regulatory requirements.


The Physician Advisor will report to the Chief Medical Officer (CMO) and will be responsible for performing duties according to organizational objectives, hospital policies, standards of practice, and Federal and State regulations.


Key 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.


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