Physician Advisor: Care Management & CDI

ACPM; Texarkana, Northern (TX, KY); Hybrid; USD 180.000 - 240.000; Vollzeit

Benefits dieser Stelle

Balanced professional and personal生活

Competitive compensation and benefits

No state income tax

Relocation assistance

Zusammenfassung

CHRISTUS St. Michael hospital- Texarkana is seeking a Physician Advisor for Care Management & CDI. You will supervise physician documentation, promote compliant MS-DRG assignments, and collaborate with CM and medical staff on utilization review.

This is a full-time role with no call responsibilities, reporting to the Chief Medical Officer. Requirements include a licensed physician in the state, board certification in a clinical specialty, and preferred ABQUARP certification.

Qualifikationen

• 5 years of clinical experience
• Licensed physician in state of residence
• Board certified in a clinical specialty
• Certified by ABQUARP - preferred
• Experienced in utilization review
• Served on/chaired Utilization Management Committee
• Demonstrated cost-efficient practice

Aufgaben

• Lead Utilization Review Committee in collaboration with CM Director
• Conduct secondary status reviews for appropriate level of care determination
• Perform peer-to-peer with payor medical directors to resolve medical necessity issues
• Monitor UM metrics and participate in actions to reach targets (denials, appeals, LOS)
• Educate physicians and clinicians on regulatory requirements and billing status
• Mentor UR Case Managers to increase knowledge in care progression
• Provide feedback on clinical documentation using case examples

Kenntnisse

Clinical experience

Licensed physician

Board certification

ABQUARP (preferred)

Utilization review

Utilization Management

Cost-efficient practice

Tools

InterQual knowledge

MCG criteria knowledge

ABQUARP certification

Jobbeschreibung

CHRISTUS St. Michael hospital- Texarkana is seeking a Physician Advisor for Care Management & CDI. You will supervise physician documentation, promote compliant MS-DRG assignments, and collaborate with CM and medical staff on utilization review.

This is a full-time role with no call responsibilities, reporting to the Chief Medical Officer. Requirements include a licensed physician in the state, board certification in a clinical specialty, and preferred ABQUARP certification.