PHYSICIAN ADVISOR

About the role

The Physician Advisor acts as a liaison between the physicians, Clinical Resource Management and the hospital administration. The Physician Advisor works as part of a team and advises physicians on medical practices that are best practice regarding throughput and appropriate levels of care. The physician advisor is responsible for staying updated with the frequent changes in rules and regulations. Demonstrates excellent customer service performance in that his/her attitude and actions are always consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare.

Responsibilities

• Communicates with physicians, especially when difficult issues arise and have critical conversations concerning resource utilization and throughput.
• Facilitate process of engaging hospital physicians to provide input on medical necessity and denial cases.
• Provides feedback to attendings and consulting physicians regarding level of care, length of stay, and quality issues.
• Seeks additional clinical information for the attending/consulting physicians.
• Recommends and requests additional, more complete, medical record documentation.
• Recommends next steps in coordination of care and evidence-based indicators.
• Provides education to physicians and other clinicians related to regulatory requirements, appropriate utilization, alternate levels of care and end of life care.
• Supports and educates physicians to facilitate referrals to the continuum of care.
• Review and focus upon patients that have excessive LOS and/or high risk for readmissions based on screening criteria
• Address unresolved consults/diagnostic delays
• Engage with attending physicians with peer-to-peer dialogue when treatment paths are ambiguous
• Assist with resolving Patient/Family/Physician conflict, esp. focus on plans/transitions of care
• Perform peer-to-peer calls with Medical Directors at Skilled Nursing Facilities, Long-Term Acute Care Hospitals, and Home Health agencies to clarify complex treatment regimens
• For high-risk cases, facilitate direct peer-to-peer communication for warm handoffs to Primary Care Providers and specialists
• Participate in root-cause analyses on avoidable patient days and operational delays, presenting actionable findings to medical executive committees and hospital leadership
• Regular participation in daily muti-disciplinary rounds on adult inpatient units
• Assist case management with length of stay reviews