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Physician Advisor (6351)

TAL Healthcare

Last Updated: 1/15/21

Job Description

Our client, a vibrant community teaching medical center, is seeking to hire an experienced Physician Advisor. The Physician Advisor will develop and grow their Physician Advisory services. The Physician Advisor will provide physician support to Care Coordinators providing Case Management and Utilization Review services. The Physician Advisor will review cases for medical necessity and educate and collaborate with residents, hospitalists and attendings in determining appropriate inpatient versus observation status.

Responsibilities:

  • Provide physician support to Care Coordinators providing Case Management and Utilization Review services.
  • Review cases for medical necessity and educate and collaborate with residents, hospitalists and attendings in determining appropriate inpatient versus observation status.
  • Participate in denial and appeal processes, acting as a member of the Utilization Review Committee,
  • Provide assistance to Clinical Documentation Improvement Specialists
  • Lead the center in the introduction of contemporary medical management practices.
  • Lead a team of residents and students from our Internal Medicine Residency.
  • Develop positive relationships to provide education to Hospitalist and Faculty Attendings, Medical Residents, and Community Attendings to support appropriate initial and follow-up documentation to support Medical Necessity and optimization of LOS.
  • Review Medical Necessity of new Patients admitted for Observation Services (maximum of 8 patients per day). The PA will not be the assigned Attending for Observation patients for a 6-month time period.
  • Lead medical providers, case management, and hospital leadership regarding hospital metrics to achieve the following improvements (to be reviewed monthly):
  • Length of Stay: Decrease by X%
  • Observation Hours: Decrease to 24 hours or less
  • Patient Status Conversion Rate, OBS to IP: 0-2%
  • Initial Clinical Denial Rate: Decrease by X%
  • Overall Win Loss Ratio: Increase to 60/40
  • Inpatient Win Loss Ratio: Increase to X
  • Post-Discharge Win Loss Ratio: Increase to X
  • Function as a resource in peer to peer reviews, denials, and appeals with commercial and governmental insurance payers.
  • Chair the Utilization Review and Utilization Management Committee.
  • Be a direct link to the medical staff and a liaison between the medical staff and hospital administration to increase and optimize utilization review and quality.

Requirements:

  • MD or DO degree
  • Board certified in Internal Medicine
  • 10+ years experience as Internal Medicine Attending Physician in teaching hospital
  • Experience as a Physician Advisor required



Company Details


TAL Healthcare

Mount Kisco, New York, United States

TAL Healthcare specializes in the recruitment and placement of physicians and clinicians throughout the New York Metropolitan area. We are exceptionally skilled at guiding both healthcare organizations and physicians and other clinicians through the process of finding the most compatible practice opportunities for both parties. We thrive at “matching great companies with great talent.”...