Physician Advisor

4 days ago

Prescott, Arizona, United States Yavapai Regional Medical Center Full time
Overview

Dignity Health-Yavapai Regional Medical Center is a leading healthcare provider in the region, offering a comprehensive range of inpatient and outpatient services. As a Physician Advisor, you will play a critical role in promoting evidence-based standards of medical care while maintaining appropriate utilization of hospital resources.

This position requires a strong clinical background, excellent communication skills, and the ability to work collaboratively with various stakeholders. You will be responsible for facilitating communication between the Department of Care Coordination, Medical Staff, Nursing Staff, and Administration regarding systems-based practice, regulatory and quality considerations in the delivery of medical care.

The ideal candidate will have a minimum of five years of clinical practice experience, be an active member in good standing of the hospital's medical staff, and possess strong collaboration skills with other physicians. If you are a motivated and detail-oriented individual who is passionate about delivering high-quality patient care, we encourage you to apply for this exciting opportunity.

Responsibilities

This position will be responsible for the following key areas:

  • 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.
  • Provide a more cost-effective delivery of secondary medical necessity reviews than what is currently provided by outside contracted services.
  • Champion good stewardship of resources.

Qualifications

The ideal candidate will possess the following qualifications:

  • Minimum of five years clinical practice experience.
  • Active member in good standing of Hospital's medical staff and participating member of various medical committees.
  • Doctor of Medicine (MD or DO).
  • Licensed to practice medicine without restrictions in the State where performing Physician Advisor duties.
  • Strong clinical judgment and technical abilities.
  • Strong collaboration skills with other physicians.
  • Excellent interpersonal and communication skills.

Benefits

We offer a comprehensive benefits package, including medical, dental, and vision insurance, flexible spending accounts, a matching 403(b) retirement program, and paid time off. Additionally, we offer tuition reimbursement, mental health benefits, and employee life insurance.

Pay Range
$76.92 - $123.07 /hour

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