Physician Advisor: Case Management & Utilization

McLeod Health; Florence (SC); On-site; USD 140,000 - 210,000; Full time

Benefits offered by this job

Sign-on Bonus

Relocation Allowance

CME Days

CME Allowance

Paid Malpractice

Full Benefits

Retirement

PSLF Eligible

Job summary

McLeod Health in Florence, SC is seeking a BC/BE Physician Advisor for Case Management Services at our flagship 565-bed tertiary care center.

The role provides clinical leadership to the case management and utilization review teams, guides documentation and resource utilization, and coordinates with payer medical directors to resolve issues, while contributing to quality improvement and policy development.

Responsibilities

• Provide clinical leadership and expert guidance to the case management and utilization review teams
• Educate and collaborate with medical staff on documentation, length of stay, level of care and resource utilization
• Serve as liaison between hospital and payer medical directors to resolve clinical and reimbursement issues
• Participate in quality improvement initiatives around readmission rates, mortality and compliance
• Review admissions, discharges and transfers for medical necessity per CMS and payer guidelines
• Support policy development and drive evidence-based care pathways

Job description

McLeod Health in Florence, SC is seeking a BC/BE Physician Advisor for Case Management Services at our flagship 565-bed tertiary care center.

The role provides clinical leadership to the case management and utilization review teams, guides documentation and resource utilization, and coordinates with payer medical directors to resolve issues, while contributing to quality improvement and policy development.