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On-site Physician Advisor Position in Suffolk, Virginia

1 month ago


Norfolk, Virginia, United States Sentara Full time
Job Summary

The Physician Advisor plays a crucial role in ensuring compliant hospital status and billing for patients. This position requires a strong understanding of regulatory requirements and the ability to communicate effectively with medical staff and hospital leadership.

The ideal candidate will have a medical degree, board certification, and at least 3 years of clinical experience. They will also possess excellent customer service and interpersonal skills, as well as the ability to present information effectively.

This is a tobacco-free environment, and Sentara Healthcare values diversity and inclusiveness. The organization is committed to ensuring its workforce reflects the communities it serves.

Responsibilities
  • Perform timely and compliant medical necessity reviews
  • Facilitate denials management and assist with appeals letters
  • Work closely with hospital leadership, medical staff, and hospital ICM leaders to support system CPIs and initiatives
  • Attend and participate in Hospital UM committees at designated sites
  • Complete training and continuing education as deemed necessary
  • Attend and participate in educational presentations to medical staff, administration, leadership, and peers
Requirements
  • Completion of Medical doctorate or Doctor of Osteopathy degree from an accredited medical school
  • Completion of an accredited residency training program
  • Minimum of 3 years of clinical experience, hospital clinical experience strongly preferred
  • Active and unrestricted state Virginia medical license
  • Board certification in specialty required at time of hire
  • Familiarity with standard published leveling criteria such as MCG/Interqual and ability to apply professional judgment and patient-specific variables as may be necessary or justifiable
  • Familiarity with (Hospital) organization and case management operations
  • Excellent customer service and interpersonal skills
  • Able to effectively present information, both formal and informal
  • Superb written and verbal communications skills
  • Ability to set and manage priorities
  • Demonstrate flexibility, teamwork, and a collaborative leadership style
  • Strong technical/computer skills and working knowledge of the system's EMR