Physician Advisor

About the Role

Responsible for medical staff leadership to the Utilization Management Committee (UMC) and the Case Management (CM) and Health Information Management (HIM)/Clinical Documentation Improvement Departments. Leads and promotes processes for patients to receive medically necessary and high-quality care throughout the continuum of care. Stays abreast of professional best practices and community standards of care. Assists Administration in reducing financial risks associated with denials due to medically unnecessary or preventable services and extended length of stays.

Responsibilities

• Provide and document ongoing education and in-service instruction programs for Hospital’s nursing and ancillary personnel related to the Program, focusing on coding, compliance, utilization management, and quality issues.
• Conduct and document reviews to determine medical necessity and level of care issues when patients do not meet Interqual criteria and for cost and length of stay (LOS) outliers as referred by non-physician reviewers.
• Provide consultation for the Risk Manager and liaison with physicians in matters of reportable events (e.g., Code 15s) and disclosure of unanticipated outcomes in compliance with JCAHO standards and patient safety policy, particularly in relation to conflicts about end-of-life issues.
• Make recommendations to Hospital’s administration regarding the use of Hospital personnel, necessary equipment, and general quality standards of patient care.
• Develop and document ongoing medical education and in-service instruction programs for Hospital’s medical staff relating to issues identified by the Program, focusing on coding, compliance, utilization management, quality, and patient safety issues, and recommend changes to Hospital’s policies and procedures.
• Attend and serve as a liaison to appropriate Medical Staff Committees relevant to the Program to provide input and guidance, ensuring appropriate actions are taken when necessary to mediate conflicts (e.g., Medical Executive Committee, PIM Committee, Patient Safety Committee, and Medical Staff Peer Review Committees).

Requirements

• Education: Doctor of Medicine Degree (M.D.) or Doctor of Osteopathic Medicine Degree (D.O.).
• Experience: 2 years in a physician leadership role. Preference for experience in Utilization Management and hospital committee chair roles, with demonstrated ability to work collegially with medical staff and engage in education.
• Licensure/Certifications: Current State MD or DO License and an ABMS (American Board of Medical Specialties) Certification.

Preferred Requirements: Advanced degree in Business and/or Health Care Administration.

Benefits

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance Program
• Employee discount program
• Voluntary benefits including pet insurance, legal insurance, accident and critical illness insurance, long-term care, elder & childcare, auto & home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status.

About the Organization

Abrazo West Campus is recognized for providing exceptional, comprehensive care to patients in West Valley communities. The 200-bed acute care hospital offers advanced services, including the da Vinci Xi surgical platform, Level I Trauma Center, Loop-X system, orthopedics, obstetrics, and cardiovascular care.