CommonSpirit Health was formed by the alignment of Catholic Health Initiatives (CHI) and Dignity Health. With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community.
This is a remote position, and we prefer at this time that you be licensed in the state of Texas. Candidates licensed in other states will be considered for future openings.
As the Utilization Management Physician Advisor II, the Physician Advisor (PA) conducts clinical case reviews referred by case management staff and/or other health care professionals to meet regulatory requirements and in accordance with the hospital’s objectives for assuring quality patient care and effective and efficient utilization of health care services. The PA meets with case management and health care team members to discuss selected cases and make recommendations for care as well as interacting with medical staff members and medical directors of third- party payers to discuss the needs of patients and alternative levels of care. The PA acts as a consultant to, and resource for, attending physicians regarding their decisions relative to appropriateness of hospitalization, clinical documentation, continued inpatient stay, and use of healthcare resources. The PA further acts as a resource for the medical staff regarding federal and state utilization and quality regulations. The PA will act as a liaison between OneCare (electronic health record capabilities) and the medical staff ensuring that the system is optimized for effective physician use. The PA helps facilitate training for the physicians. The PA must demonstrate interpersonal and communication skills and must be clear, concise and consistent in the message to all constituents.
Broad-based knowledge regarding clinical practice.
Broad knowledge base with trust and respect of medical staff physicians.
In-depth knowledge of CMS regulations, including understanding of the 2-midnight rule.
Utilization management experience.
Education in quality and utilization management through continuing medical education programs and self-study.
Knowledge of and practical use of good business English, spelling, arithmetic, practices and the ability to communicate effectively using written and verbal skills.
While you're busy impacting the healthcare industry, we'll take care of you with benefits that include:
Medical/Dental/Vision, FSA, Dependent Care Spending Account, Life Insurance, Short and Long-term Disability, 401k match, Paid Time Off, Wellness Program, Tuition Reimbursement, Accidental Insurance, Critical Illness Insurance, Identity Theft Protection, Employee Assistance Program, and more!
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