Physician Advisor

Wellstar Health System; Roswell (GA); On-site; USD 180,000 - 240,000; Full time

Job summary

Wellstar Health System in Georgia seeks a Physician Advisor to impact quality, utilization, and patient outcomes through performance improvement and education initiatives. You will work with the CMO and hospital leadership to assure appropriate care and efficient resource use.

The role requires MD/DO with board certification preferred and additional MBA or MHA preferred. Significant clinical experience in utilization management and hospital quality programs is expected.

Qualifications

• Doctorate Medicine or Doctorate Osteopathic Medicine required.
• Board certification in specialty preferred.
• Healthcare quality and management certification preferred.

Responsibilities

• Lead utilization management and conduct clinical reviews for appropriateness of care.
• Collaborate with care management, administration, and physicians to optimize resource use.
• Drive quality improvement initiatives and patient safety objectives with hospital leadership.
• Lead efforts to reduce avoidable readmissions and improve outcomes.

Skills

Clinical leadership

Utilization management

Quality improvement

Cross-functional collaboration

Education

MD/DO

MBA

MHA

Job description

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what’s possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people’s lives.

Work Shift

Job Summary:

The Physician Advisor reports to and is accountable to the Chief Medical Officer to impact quality, utilization, patient satisfaction and efficiency metrics through Performance Improvement and education initiatives that will enable the facility to achieve its stated goals. Working in collaboration with the CMO(s) in the WellStar Health System (WHS), the Physician Advisor (PA) will be involved in the following areas:

Utilization Management: The Physician Advisor (PA) will conduct clinical review on cases for commercial payers and medicare advantage plans that are referred by Care Coordination/Case Management staff and/or other health care professionals to assess for appropriateness of care; proper level of care in accordance with hospital objectives for assuring quality patient care and effective, efficient utilization of health care services, and to meet regulatory requirements. Working as a peer to physicians and as a consultant to Care Management and administration, the PA intervenes when practice patterns or behaviors or documentation issues create disparity between pathway standards, intensity of service, severity of illness, patient and family rights, teamwork, or other issues regarding the stewardship of resources for individual patients, diagnostic populations, and the organization as a whole. In the area of Readmissions, the Physician Advisor will help to lead the effort to reduce avoidable readmissions. The Physician Advisor will engage with Physicians, Advanced Practice Professionals, nursing and other ancillary personnel as well as administrative leaders as part of his/her role in Performance Improvement, Resource Utilization and ongoing education on imp8ortant trends in healthcare management. Quality Improvement: In addition to the above duties, the PA will work with the CMO and the Quality Director or Manager at the hospital on quality improvement initiatives to assist the hospital to achieve its annual goals.

Required Minimum Education:

• Doctorate Medicine or Doctorate Osteopathic Medicine
• Masters Business Administration/Management-Preferred or Masters Health Administration-Preferred

Required Minimum License(s) and Certification(s):

All certifications are required upon hire unless otherwise stated.

• DO - Doctor of Osteopathic Medicine or MD - Medical Doctor

Additional License(s) and Certification(s):

• Board certified in specialty of practice preferred
• Health Care Quality & Management Certification, (i.e. ABQAURP or equivalent) preferred

Required Minimum Experience:

• Minimum 8 years 8-10 years clinical experience Required Minimum
• 1 year One (1) to three (3) years of experience post residency in Utilization Management experience with focus on clinical documentation, medical necessity assessment, billing and coding acumen, business, strategic planning, financial planning and development.

Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.