Physician Advisor

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Conducts case reviews across all categories with expertise and diligence to ensure maximum compliance.

• Collaborates closely with the medical leadership of the Client, along with the entire medical team, including resident physicians.

• Recognizes opportunities to enhance hospital stay durations and resource management efficiency.

• Guarantees that patients are placed in suitable care levels, along with necessary documentation, coding enhancements, and compliance.

• Addresses inquiries regarding clinical reviews for medical necessity.

• Offers consultation to attending physicians, nurses, and case management personnel on intricate clinical matters.

• Utilizes professional judgment and patient-specific factors when required or justifiable.

• Holds accountability for attaining case management results.

• Suggests improvements for health record documentation that directly impact ICD code assignment related to severity, acuity, mortality risk, and DRG assignment.

• Engages in continuous training and education pertinent to the Physician Advisor position.

• Meets established productivity and quality benchmarks within designated timeframes.

• Accomplishes performance objectives as specified in the employment contract.

• Upholds the confidentiality of patient care and business concerns.

• Exhibits conduct that aligns with the organization's mission.

• Aids, mentors, and instructs other physicians on payer requirements.

• Attends all meetings as requested by PAOC leadership.

• Engages in the peer review process as necessary or as requested.

• Maintains medical licensure and board certification in good standing.

• Devotes full attention to the Physician Advisory role and the execution of assigned tasks.

• Performs other duties as assigned.

⛳️ Requirements

• Board Certified and licensed to practice medicine in the United States or possess 3+ years of active clinical experience in the US.

• 3+ years of experience as a Physician Advisor, conducting Level of Care reviews and Peer to Peer Reviews.

• Basic technical proficiency with Hospital EMRs is essential.

• Must hold and maintain an unrestricted medical license and Board Certification.

• Should possess or acquire a strong foundation, knowledge, and/or experience in utilization management, quality improvement, and patient safety.

• Must have a working understanding of hospital organization, case management operations, and administrative standards and policies.

• Familiarity with MCG/InterQual placement criteria is preferred.

• Membership in the American College of Physician Advisors (ACPA) is preferred.

• Board Certification from the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is preferred.

• Physician Advisor Sub-Specialty Certification from ABQAURP is preferred.

• Ability to effectively present information in both formal and informal contexts.

• Strong analytical abilities.

• Proficiency in the Microsoft Office Suite.

• Excellent interpersonal skills with the capability to communicate effectively at all organizational levels.

• Strong problem-solving and creative skills, along with the ability to exercise sound judgment and make decisions based on accurate and timely analyses.

• High integrity and dependability with a strong sense of urgency and results-oriented approach.

• Exceptional written and verbal communication skills are required.

🏝️ Benefits

• Confidentiality of patient care and business matters.

• Required orientation and training related to the Physician Advisor role.