Clinical Utilization & Discharge Advisor

Aria Health; Philadelphia (Philadelphia County); On-site; USD 180,000 - 240,000; Full time

Benefits offered by this job

Health benefits

Retirement plan

Paid time off

Job summary

Jefferson Health in Philadelphia seeks a Physician Advisor to provide consultation on level of care, utilization of resources, and discharge options. The role collaborates with physicians, case managers, and other clinicians to improve care efficiency and documentation across the hospital.

Responsibilities include peer-to-peer reviews, overturning denials with payors, and aiding in transitions of care. A medical degree and 5 years of direct hospital patient care are required.

Qualifications

• Medical degree required.
• Five (5) years delivering direct patient care in a hospital setting.

Responsibilities

• Interacts with coworkers and staff in alignment with Jefferson values.
• Reviews patient clinical information to determine appropriate status and care needs.
• Performs peer-to-peer reviews to overturn payer denials.
• Writes backend appeals to overturn payer denials.
• Collaborates with Case Managers on discharge planning and with Providers on level-of-care decisions.
• Expedites discharges to complete workups and transitions of care.
• Participates in trainings as needed.

Skills

Interpersonal skills

Communication

Conflict management

Team collaboration

Process improvement

Tech savvy

Education

Medical Degree

Job description

Jefferson Health in Philadelphia seeks a Physician Advisor to provide consultation on level of care, utilization of resources, and discharge options. The role collaborates with physicians, case managers, and other clinicians to improve care efficiency and documentation across the hospital.

Responsibilities include peer-to-peer reviews, overturning denials with payors, and aiding in transitions of care. A medical degree and 5 years of direct hospital patient care are required.