Physician Advisor II
Partnering for a stronger, healthier world.
At CommonSpirit Health, we believe in the healing power of humanity. We invite you to explore our specialty areas and pursue a career in humankindness.
- Department: Hospitalist
The posted compensation range of $97.31 - $155.69 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
Job Details
CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
Responsibilities
This is a remote position, and we prefer at this time that you be licensed in the state of Texas. Candidates licensed in other states will be considered for future openings.
As the Utilization Management Physician Advisor II, the Physician Advisor (PA) conducts clinical case reviews referred by case management staff and/or other health care professionals to meet regulatory requirements and in accordance with the hospital’s objectives for assuring quality patient care and effective and efficient utilization of health care services. The PA meets with case management and health care team members to discuss selected cases and make recommendations for care as well as interacting with medical staff members and medical directors of third- party payers to discuss the needs of patients and alternative levels of care. The PA acts as a consultant to, and resource for, attending physicians regarding their decisions relative to appropriateness of hospitalization, clinical documentation, continued inpatient stay, and use of healthcare resources. The PA further acts as a resource for the medical staff regarding federal and state utilization and quality regulations. The PA will act as a liaison between OneCare (electronic health record capabilities) and the medical staff ensuring that the system is optimized for effective physician use. The PA helps facilitate training for the physicians. The PA must demonstrate interpersonal and communication skills and must be clear, concise and consistent in the message to all constituents.
Key Responsibilities
- Conducts medical record review in appropriate cases for medical necessity of inpatient admission, need for continued hospital stay, adequacy of discharge planning and quality care management.
- 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 on severity of illness, acuity, risk of mortality, and communicate with treating physicians in cooperation with the utilization team and health information personnel
- Serve as a liaison between the national care management team, medical staff, and medical executives to encourage physician cooperation and understanding of documentation importance
- Assist in communications of internal physician advisor services in the hospital newsletters and other communication vehicles to further educate the medical staff
- Communicate feedback on program results to facility leadership (i.e. CMO, Care Management Directors, Quality Directors)
- Provides feedback and education to the Care Management and Clinical Documentation Departments through written and verbal communication as well as appropriate tracking and trending for process improvement efforts.
- Attends and participates in facility committee meetings, by invitation, as applicable:
- Clinical Documentation Steering Committee
- Extended Length of Stay Rounds
- Utilization Review Committee
- Care Management Staff Meetings
- Contacts Attending Physicians: Makes face-to-face and telephonic/electronic contacts and presentations to all medical staff physicians and potential physician groups introducing referral services, new products and present product offerings.
- Conducts Peer to Peer discussions with payers as needed: Acts as a liaison and coordinator with operations for physicians. Attends applicable committee meetings, such as a Joint Operating Committee (JOC), as requested by Utilization Management or Managed Care: Works with the Care Management Director and staff to facilitate client profiles, clinical service utilization and support for revenue management activities.
Qualifications
- MD or DO required
- Minimum 3 years of experience as a Physician Advisor required
- Minimum 5 years of experience in Clinical Practice required
- Experience performing Peer to Peer Reviews required
- Unrestricted license in field of practice in one or more states, Texas preferred
Broad-based knowledge regarding clinical practice.
Broad knowledge base with trust and respect of medical staff physicians.
In-depth knowledge of CMS regulations, including understanding of the 2-midnight rule.
Utilization management experience.
Education in quality and utilization management through continuing medical education programs and self-study.
Knowledge of and practical use of good business English, spelling, arithmetic, practices and the ability to communicate effectively using written and verbal skills.
While you're busy impacting the healthcare industry, we'll take care of you with benefits that include:
Medical/Dental/Vision, FSA, Dependent Care Spending Account, Life Insurance, Short and Long-term Disability, 401k match, Paid Time Off, Wellness Program, Tuition Reimbursement, Accidental Insurance, Critical Illness Insurance, Identity Theft Protection, Employee Assistance Program, and more!
#LI-CSH
#LI-Remote
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.
Nursing excellence
starts with you.
Are you a career fit with our CommonSpirit Health culture? To understand how we are structured, we believe in some core philosophies with the following:
We will be stronger together, achieving excellence in all we do, collaborating across the fields and growing our collective knowledge.
We will let humankindness guide us as we treat every person with holistic, personalized care for the body, mind and spirit.
We will advance the science and art of nursing as innovative leaders who demonstrate the power of evidence-based, compassionate care. If you believe in working together with humankindness for all to advance the science and art of nursing - then you have found your career fit with us!
“Our hope is that you will always feel inspired, knowing you truly are the heart and soul of CommonSpirit.”
– Kathleen D. Sanford, EVP, Chief Nursing Officer
Your Potential Career Path
This is a snapshot of your potential career path highlights the series of job positions that help you progress towards your goals and objectives. Ultimately, your career path depends on your career values and personal goals.
![Career path shows a list of jobs that someone could get by getting promotions at this company: 1. Student Nurse 2. New Grad Nurse 3. Staff Nurse 4. Educator 5. Charge Nurses/ Supervisors 6. Nurse Practitioner 7. Managers/Directors 8. CNE](https://tbcdn.talentbrew.com/company/35300/img/v1_0/career-path/commonspirit-careerpath-desktop.png)
Success Profile
What makes a successful Physician at CommonSpirit Health?
- Compassionate
- Trustworthy
- Proactive
- Collaborative
- Communicator
- Balanced
Our Total Reward Offerings
At CommonSpirit Health, we believe investing in our employees lets them know they truly matter. Your Total Rewards package includes compensation, benefits, retirement, wellness, leave, and other programs.
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