Physician Advisor

CHI St. Alexius is looking for a Physcian Advisor to join the team!

The Onsite Physician Advisor (PA) will serve as a physician leader and advocate for the improvement of a hospital’s utilization management, regulatory compliance, quality assurance, revenue integrity, and risk management. The Onsite PA will work in conjunction with the Care Coordination team to address areas of high importance and/or concern in the appropriate, effective, and efficient movement of a patient through their hospital encounter (e.g. accurate level of care determination, extended length of stay, appropriate discharge planning). As a respected member of the Medical Staff, the Onsite PA will participate in, if not Chair, the UM Committee, in addition to other key hospital committees (e.g. CDI, QA). They will also serve as a resource for, and consultant to, UM staff and attending physicians regarding decisions relative to appropriateness of hospitalization and level of care, clinical documentation, extended stays, avoidable days, readmissions, and use of healthcare resources. The PA will be a resource for the UM and Medical Staff regarding federal and state utilization and quality regulations, as well as, help to facilitate training and education sessions. 

What You'll Do:

• Provide leadership and oversight of facility-based physician advisory services. 
• Understand the intricacies of ICD-9-CM, ICD-10-CM/PCS, MS-DRG, APR-DRG, and the Medicare Inpatient Prospective Payment System (IPPS) to make medical determinations based on severity of illness, acuity, and risk of morbidity/mortality. 
• Review clinical record for medical necessity of acute hospital-based care on admission (as needed-e.g. condition code 44), as well as, throughout the hospital encounter; identifying appropriate opportunities for discharge planning and quality improvement. 
• Communicate, as appropriate, medical necessity assessments with treating physicians in cooperation with the utilization team and health information personnel. 

• Attend, participate and/or chair in facility-based: 
• Extended Length of Stay (LOS) Rounds 
• Multidisciplinary Rounds 
• Utilization Review Committee Meetings 
• Clinical Documentation Improvement (CDI) Committee Meetings 
• Quality improvement and safety committee 
• Collaborate with Care Coordination to assist in management of extended LOS encounters, specialty cases, and high-risk cases, in addition to serving as a resource for process improvement. 
• Maintain UM committee membership and support
• Champion/advocate and support CDI, regulatory compliance, and improved utilization of hospital resources. 
• Support Revenue Integrity through assistance with Denial Prevention, Denial Management (e.g. Peer to Peer Review with payors when appropriate) and Regulatory Compliance. 
• Champion, collaborate and support Quality Assurance, and Risk Management in the facility . 
• Provide routine education and guidance to UM, Medical Staff and residents on regulatory, quality, and/or cost of care opportunities thereby supporting value based care initiatives. 
• Bridge communication between Care Coordination team and Medical Staff 
• Track, trend, and analyze -decided upon-performance and process improvement metrics for facility, UM/Medical Staff, and Physician Advisor program. 
• Communicate facility feedback and metrics to Executive leadership (i.e. CMO, Care Management Directors, Quality Directors etc.) 
• Serve as a liaison between the National Care Coordination and Physician Advisor teams with the facility-based Care Coordination teams, Medical Staff, and Executive Leaders. 

Required Education:

Graduate of an accredited medical school

Required Licensure and Certifications:

MD or DO licensure within the state of employment

Required Minimum Knowledge, Skills and Abilities

Board Eligible in the area of clinical practice.

Preferred Qualifications:

Board Certification in area of clinical practice (ABMS) 

Minimum of five years of clinical practice experience.

Three years of experience as a Physician Advisor and/or other leadership experience in acute care settings with focus on utilization management and quality assurance and improvement.

Utilization management experience as chair or as a member of an UM  oversight committee. 

Leadership involvement and/or management experience of quality ssurance. 

Management experience in care efficiency and throughput in acute care hospital settings.

Since 1885, CHI St. Alexius Health has been dedicated to leading health care in this region by enriching the lives of patients through the highest quality of care. We seek to continue our tradition of success and innovation with individuals dedicated to delivering the highest level of expertise and quality. Together we can continue to grow and support the legacy of CHI St. Alexius Health for many years to come.

CHI St. Alexius Health is a regional health network with a tertiary hospital in Bismarck, the system also consists of critical access hospitals (CAHs) in Carrington, Dickinson, Devils Lake, Garrison, Turtle Lake, Washburn and Williston and numerous clinics and outpatient services.  CHI St. Alexius Health manages four CAHs in North Dakota - Elgin, Linton, and Wishek, as well as Mobridge Regional Medical Center in Mobridge, S.D. CHI St. Alexius Health offers a comprehensive line of inpatient and outpatient medical services, including: a Level II Trauma Center, primary and specialty physician clinics, home health and hospice services, durable medical equipment services, a fitness and human performance center and ancillary services throughout western and central North Dakota.

CHI St. Alexius Health is part of CommonSpirit Health, a nonprofit, Catholic health system dedicated to advancing health for all people. It was created in February 2019 through the alignment of Catholic Health Initiatives and Dignity Health. CommonSpirit Health is committed to creating healthier communities, delivering exceptional patient care, and ensuring every person has access to quality health care.

CHI St. Alexius also provides you with the quality care you provide to others. We care about our employees well-being and offer benefits that complement work/life balance.

We offer the following benefits to support you and your family: 

• Care@Work program supporting any child care, pet care, or adult dependent needs 
• Employee Assistance Program (EAP) for you and your family 
• Health/Dental/Vision Insurance 
• Flexible spending accounts 
• Voluntary Protection: Group Accident, Critical Illness, and Identity Theft 
• Adoption Assistance 
• Paid Time Off (PTO) 
• Tuition Assistance for career growth and development 
• Matching Retirement Programs 
• Wellness Program

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.