Physician Advisor – Case Management & Utilization

McLeod Health; Florence (SC); On-site; USD 180,000 - 230,000; Full time

Benefits offered by this job

Competitive compensation

Full benefits

Retirement

Sign-on bonus

Relocation allowance

CME days

CME allowance

Paid malpractice

PSLF eligible

EPIC EMR

Leadership development program

Job summary

McLeod Health, Florence, SC, seeks a BC/BE Physician Advisor for Case Management Services at our flagship 565-bed center. The on-site role provides clinical leadership to case management and utilization review teams.

You will educate staff on documentation, length of stay, level of care, and resource utilization, and review admissions/discharges/transfers for medical necessity under CMS and payer guidelines. PSLF eligible with comprehensive benefits.

Qualifications

• Experience in case management and utilization review leadership.
• ABMS board certified/eligible physician advisor with hospital experience.
• Strong collaboration with medical staff and payer relations.

Responsibilities

• Provide clinical leadership to the case management and utilization review teams.
• Educate and collaborate with medical staff on documentation, LOS, level of care, and resource use.
• Serve as liaison between hospital and payer medical directors to resolve issues.
• Participate in quality improvement initiatives around readmissions, 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.

Skills

Clinical leadership

Utilization review

Documentation accuracy

Interdisciplinary collaboration

Education

BC/BE Physician Advisor

Tools

EPIC EMR

Job description

McLeod Health, Florence, SC, seeks a BC/BE Physician Advisor for Case Management Services at our flagship 565-bed center. The on-site role provides clinical leadership to case management and utilization review teams.

You will educate staff on documentation, length of stay, level of care, and resource utilization, and review admissions/discharges/transfers for medical necessity under CMS and payer guidelines. PSLF eligible with comprehensive benefits.