Physician Advisor – Utilization & Care Optimization

Ensemble Health Partners; Blue Ash (OH); Presencial; USD 198.000 - 297.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Healthcare benefits

Tuition reimbursement

Professional development

Descripción de la vacante

Ensemble Health Partners is seeking a Physician Advisor to lead resource and utilization management for quality, cost-effective care. You will work with medical staff leadership to optimize hospital services, support documentation, coding improvements and compliance, and perform peer reviews and denials/appeals as needed.

You will educate staff, participate in UM processes, and report to leadership while building consensus across departments to improve overall utilization management outcomes.

Formación

• MD/DO physician required.
• Strong leadership and collaboration with medical staff.
• Excellent executive communication and decision-making skills.

Responsabilidades

• Status determinations for hospitalized patients.
• Peer-to-peer reviews with payors’ medical directors.
• Short inpatient stay reviews.
• Review observation patients daily.
• Build relationships with medical staff and leadership to gain buy-in on UM issues.
• Attend UM Committees as subject matter expert.
• Assist with denials and appeals as appropriate.
• Educate medical staff on UM topics.

Conocimientos

Leadership

Executive communication

Decision making

Collaboration

Educación

MD/DO Physician

Descripción del empleo

Ensemble Health Partners is seeking a Physician Advisor to lead resource and utilization management for quality, cost-effective care. You will work with medical staff leadership to optimize hospital services, support documentation, coding improvements and compliance, and perform peer reviews and denials/appeals as needed.

You will educate staff, participate in UM processes, and report to leadership while building consensus across departments to improve overall utilization management outcomes.