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Physician Advisor II

Houston, Texas; Remote

CommonSpirit Health

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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.

Requisition ID 2024-342139 Employment Type Full Time Hours/Pay Period 80 Provider Physician Provider Type MD/DO Speciality Hospitalist Weekly Schedule Monday - Friday (8:00 AM - 5:00 PM) Remote Yes Category Non-Clinical Provider Recruiter Name Ricci Barton Recruiter Email RicciBarton@catholichealth.net
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Job Details

Overview

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

While you’re busy impacting the healthcare industry, we’ll take care of you with benefits that may include health/dental/vision, FSA, matching retirement plans, paid time off, tuition assistance, adoption assistance, and more!

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

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.

  • Pay and Recognition

  • Balanced Life

  • Well-Being

  • Professional Growth

  • Financial Future

  • Dependent Care

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Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.