Physician Advisor Liaison

Found in: Lensa US P 2 C2 - 2 weeks ago


Redwood City, United States CommonSpirit Health Full time

Overview:

The Physician Advisor in addition to assisting in the review of specific cases recognizes and trends patterns of physician utilization and communicates patterns and trends to the Utilization Management Committee and other Medical Staff Committees as indicated.About Sequoia Hospital Hello HumankindnessDignity Health Sequoia Hospital is an accredited not-for-profit community hospital providing innovative and exceptional health care for generations of Bay Area residents. Sequoias Heart and Vascular Institute is a nationally known pioneer in advanced cardiac care affiliated with the Cleveland Clinic Heart and Vascular Institute. Sequoia has received national recognition from Healthgrades for superior patient safety and was named as one of Americas top 100 hospitals for cardiac care. Our Total Joint Replacement program is a designated Blue Distinction Center for Knee and Hip Replacement. Our Birth Center is consistently ranked as a favorite among Peninsula families. We are also known for our comprehensive emergency care and leading-edge tomosynthesis 3-D mammogram technology. Our Pavilion combines the most advanced medical and surgical services with a unique healing environment including private spacious rooms and inviting garden areas.

Responsibilities:

The Physician Advisor plays a critical role in promoting evidence-based standards of medical care while maintaining appropriate utilization of hospital resources. Emphasis is on 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 Physician Advisor plays a significant role in the following: advocating for the best and most efficient care for hospital patients; removing barriers to care; working with attending physicians to facilitate the care of the patient; and advocating for, supporting, and enhancing the clinical credibility of the department of care coordination's utilization and compliance activities. The Physician Advisor will report directly to the Chief Medical Officer. Physician Advisor shall participate in an annual performance evaluation using performance metrics adopted by Hospital.

Key Responsibilities Include:

  • Provides secondary review and the application of medical rationale and decision making to referred cases and provides outcome of secondary review for documentation in the Utilization Review records (either paper or MIDAS/CERMe) of the individual patient.
  • Participates in activities as needed to actively manage avoidable days and improve efficiency of consultations, tests and surgery scheduling, hospital and physician weekend efficiency, last minute discharges and over and under utilization.
  • Effectively participates in communication as needed with physicians, organizations, payers and IPA's in activities such as RAC appeals, audits and secondary review. Will represent Sequoia during ALJ hearings.
  • The Physician Advisor in addition to assisting in the review of specific cases recognizes and trends patterns of physician utilization and communicates patterns and trends to the Utilization Management Committee and other Medical Staff Committees as indicated.
  • Provides Utilization Management Committee or appropriate Medical Staff Committee with ongoing validated information about the treatment and flow of patients throughout all levels of care.
  • Articulates the importance of physicians' cooperation in working with the mission of the hospital and health system including stewardship, efficiency of care and support of case management, clinical social work and all hospital disciplines.
  • Effectively meets customer needs; builds productive customer relationships; takes responsibility for customer satisfaction and loyalty.

SIGN ON BONUS AND RELOCATION ASSISTANCE ELIGIBLE

Qualifications:

Requirements:

  • At least 5 years experience practicing medicine in a recognized hospital or office environment.
  • CA Physician license
  • MD
  • Excellent communication skills and clinical knowledge, ability to interact with multiple other physicians in a collaborative and positive way in order to improve the quality of patient care. Highly organized and able to interact with multidisciplinary groups for the benefit of the patients. Must be able to read, write and speak English.

Preferred:

  • Certification in Health Care Quality Management (HCQM)
  • 2 years work experience as a Physician Advisor and Membership in the American College of Physician Advisors.

#LI-DH


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