Physician Advisor 7 on 7 off

Brundage Medical Group LLC; Oregon; Hybrid; USD 110,000 - 160,000; Full time

Job summary

Brundage Medical Group LLC in Oregon is seeking an experienced Physician Advisor to lead utilization management functions in a hospital setting.

You will review records, perform 2nd level reviews, and collaborate with the UM/CM team to optimize care, reduce readmissions, and ensure appropriate resource use. Board-certified or eligible physicians with 1–3 years hospital-based physician advisor experience preferred.

Qualifications

• MD/DO with current, unrestricted medical license in state of residence.
• 1–3 years of physician advisor experience in a hospital setting.
• Strong communication and interpersonal skills.

Responsibilities

• Review medical records and perform status determinations for Medicare and other payors.
• Collaborate with UM/CM team to ensure appropriate continuity of care and reduce readmissions.
• Communicate with medical staff via secure channels to relay information and provide education.
• Act as liaison between Utilization Management and providers to optimize plans of care.
• Review denials and assist with appeals as needed.
• Provide guidance to ED physicians and UM/CM on alternatives to acute care.

Skills

Utilization Management

Interpersonal skills

Written communication

Independent work

Relationship building

Education

MD/DO

Tools

EMR systems

Job description

Please note: Experienced Physician Advisor's only and no part time inquiries

DUTIES AND RESPONSIBILITIES:

Utilization Management Functions

• Reviews medical records of patients identified by the UM team or as requested by the healthcare team
• Perform status determinations including 2nd level reviews and continued stay reviews for traditional Medicare patients and all other payors
• Review Code 44 cases
• Assist with length of stay management
• Work with case management and the interdisciplinary team to ensure appropriate continuity of care and reduce readmissions
• Communicate with the medical staff through secure email, secure texting applications, phone calls and face to face interactions to relay important information and provide education
• Act as a liaison between Utilization Management/Case Management and providers to collaborate on appropriate plans of care
• Review and suggest improvements related to resource allocation
• Optimize coordination of care processes
• Provide guidance to ED Physicians and the UM/CM team regarding alternatives to acute care

Denials Management Functions

• Review denials and author appeal letters as needed
• Perform peer to peers with payors
• Act as a liaison with payors to facilitate approvals and prevent denials or carved out days when appropriate
• Other duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Expertise in Utilization Management preferred
• Strong interpersonal skills
• Excellent written and verbal communication skills
• Ability to work independently
• Ability to build relationships with key hospital team members

WORK EXPERIENCE, EDUCATION AND CERTIFICATIONS:

• MD or DO
• Current, unrestricted medical license in state of residence
• Demonstrated ability to build rapport with medical staff and hospital leadership
• Strong computer skills and working knowledge of EMRs
• 1-3 years of Physician Advisor experience and clinical experience in a hospital-based setting

Preferred Qualifications:

• Board Certified / Eligible
• CCDS or CDIP
• CCS
• CHCQM certification (ABQAURP)

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

Conditions typically associated with an office environment. While performing the essential duties and responsibilities, the employee is regularly required to talk or hear. May be frequently required to sit, stand or walk. Moderate to prolonged reading, typing, and computer work. Ability to perform tasks involving physical activity that may include lifting 25 pounds. Subject to exposure to all environmental hazards associated with healthcare and office work.