Physician Advisor — Utilization & Revenue Cycle Leader

Ensemble Health Partners; United States; On-site; USD 198,000 - 297,000; Full time

Benefits offered by this job

Benefits package

Tuition reimbursement

Recognition programs

Job summary

Ensemble Health Partners is seeking a Physician Advisor to lead resource and utilization management to deliver quality, cost-effective care in the most appropriate setting. You will collaborate with medical leadership, develop care management protocols, support documentation, coding improvements and compliance, and provide education to the medical staff.

The role requires MD/DO with clinical leadership experience and will report to the medical leadership team.

Qualifications

• MD/DO Physician (MUST have).

Responsibilities

• Status determinations for hospitalized patients
• Perform peer to peers with payors’ medical directors
• Short inpatient stay reviews
• Review observation patients daily
• Build relationship with medical staff and leadership to get their buy-in with UM issues
• Attend UM Committees as subject matter expert
• Assist with denials and appeals as appropriate
• Educate medical staff on UM topics
• Partner with UR nurses, IA staff, and Case Management to maintain and improve UM processes
• Track denial trends to evolve to meet payor challenges

Education

MD/DO Physician

Job description

Ensemble Health Partners is seeking a Physician Advisor to lead resource and utilization management to deliver quality, cost-effective care in the most appropriate setting. You will collaborate with medical leadership, develop care management protocols, support documentation, coding improvements and compliance, and provide education to the medical staff.

The role requires MD/DO with clinical leadership experience and will report to the medical leadership team.