Physician Advisor UR and CDI-Utilization Management

Baptist Health Arkansas; Little Rock, Northern (AR, KY); Hybrid; USD 180,000 - 260,000; Full time

Job summary

Baptist Health Arkansas is seeking a Physician Advisor UR and CDI-Utilization Management to lead and coordinate utilization review and documentation initiatives within the hospital leadership team.

The role focuses on teaching, consulting, and advising CDI and UR departments, while ensuring compliance with governmental and private payer regulations and accurate coding and documentation. Strong EMR skills and a solid foundation in related areas are essential.

Qualifications

• Hold an unrestricted medical license in the state.
• Meet Hospital medical staff requirements.
• Solid foundation in utilization management, quality improvement, and patient safety.
• Working knowledge of hospital organization, case management operations, and policies.
• Strong computer skills and EMR knowledge.
• Familiarity with MCG/Interqual criteria preferred.

Responsibilities

• Advise on utilization of services and documentation.
• Teach and consult with clinicians and hospital leadership.
• Oversee CDI and utilization review functions.
• Ensure compliance with payer regulations and coding/documentation requirements.
• Analyze physician practice patterns and resource use.

Skills

Utilization management

Quality improvement

Patient safety

EMR knowledge

MCG/Interqual

Tools

EMR systems

Job description

Physician Advisor UR and CDI-Utilization Management

Summary:
The Physician Advisor is a key member of the healthcare organization's leadership team and is charged with meeting the organization's goals and objectives for assuring the effective, efficient utilization of health care services. The Physician Advisor is a physician serving the hospital through teaching, consulting, and advising the Clinical Documentation Improvement and Utilization Review departments and the hospital leadership. The Physician Advisor shall develop expertise on matters regarding physician practice patterns, over and under-utilization of resources, medical necessity, levels of care, denial management, compliance with governmental and private payer regulations, appropriate physician coding and documentation requirements.

Other information

• Hold and maintain an unrestricted medical license in the state of (location).
• Meet the requirements (and become a member) of the Hospital medical staff
• Possess or acquires a solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety.
• Possess a working knowledge of (Hospital) organization & case management operations and administrative standards and policies.
• Strong computer skills and working knowledge of the EMR.
• Familiarity with MCG/Interqual placement status criteria is preferred.

This job will be authorized80.00 hours bi-weekly.

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