Full job description
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
About the role:
The Physician Advisor provides primary support for Utilization Management (UM) and secondary support for Care Management (CM) departments and serves as a liaison between UM and CM teams and medical staff, as well as, the medical liaison for payor escalations. The Physician Advisor is responsible for educating, informing and advising members of the Utilization Management, Care Management, Managed Care and Revenue Cycle departments and applicable medical staff, as well as collaborating with other disciplines to assist in the improvement of clinical documentation, patient safety, and quality outcomes.
Through primary support of Utilization Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient care/observation stays and referral services. The Physician Advisor is an important contact for clinicians, external providers, contracted health insurance payors, and regulatory agencies. This individual also serves as the subject matter expert, providing clinical expertise and business direction in support of medical management programs, promoting the delivery of high quality, patient focused and cost-effective medical care.
Responsibilities:
- Provides clinical support/validation for both Utilization Management and Care Management teams
- Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care Management structures, and functions and use of clinical guidelines
- Develops and facilitates productive internal/external relationships with all physicians and constituents of Utilization Management and Care Management
- Provides suggested approaches to clarifying clinical questions when Utilization Management and Care Management staff interact with physicians, nurses, or other health professionals
- Maintains a positive and supportive relationship between the inpatient facilities, payors and physicians (hospitalist groups and primary care providers), and acts as the interdepartmental liaison for ACO activities and program development.
Requirements:
- Graduate of accredited Medical School
- Bachelor of Science
- Minimum of 5 years of experience in hospital medicine in acute care setting
- Current and valid license as a physician
- Board certified and eligible for membership on the Hospital medical staff
Pay: $250,764.80 - $376,147.20 per year
Benefits:
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Health savings account
- Paid time off
- Parental leave
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
Work Location: Remote
