Baptist Health
Physician Advisor - Baptist Hospital of Miami, Administration, Full Time, 8:30am
Baptist Health, Miami, Florida, us, 33222
Overview
Physician Advisor - Baptist Hospital of Miami, Administration, Full Time, 8:30am-5pm Join to apply for the Physician Advisor role at Baptist Health. Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers across Miami-Dade, Monroe, Broward and Palm Beach counties. The organization is known for centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, supported by philanthropy and guided by a faith-based mission of medical excellence. Responsibilities
The Physician Advisor (PA) serves as a clinical resource to the medical staff and Case Management/Utilization (CM/SW) by identifying, facilitating and resolving utilization issues. Collaborates with admitting physicians, healthcare team and case management to proactively manage cases from entry through hospital stay to ensure appropriate level of care based on medical necessity, severity of illness and risk of mortality. Ensures CMS compliance for appropriate billing and conducts post-discharge reviews related to payer audits. Promotes understanding and cooperation between the medical staff through communication, collaboration and education. Facilitates improvements in clinical practice to achieve better performance, reduced length of stay, fewer readmissions, and superior patient care. Qualifications
Degrees: Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO). Licenses & Certifications: ABQAURP Physician Advisor Sub-Specialty Certification. Additional Qualifications: Certification as Physician Advisor by a national physician advisor organization or ABQAURP certification (or similar) must be obtained within one year of hire. Minimum 3 years of work experience as a practicing physician, with experience performing case reviews, and experience using MCG and/or InterQual criteria. Knowledge of CMS 2 Midnight Rule, Conditions of Participation, and inpatient billing requirements. Ability to analyze, organize and prioritize work while meeting deadlines; strong written and oral communication; ability to handle stressful situations with professional composure. Ability to understand and follow instructions; ability to exercise sound and independent judgment; proficiency with job-appropriate technology and software. Ongoing education in CMS guidelines, quality and utilization management through continuing medical education and self-study. Experience & Licensing
Minimum Required Experience: 3 years. Maintains active MD or DO license. If the license is not Florida, active Florida license must be obtained within one year of hire. ABQAURP certification (or equivalent) must be obtained within one year of hire. A minimum of 3 years of experience in case reviews and use of MCG/InterQual criteria is required. Equal Employment Opportunity
EOE, including disability/vets Note
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Physician Advisor - Baptist Hospital of Miami, Administration, Full Time, 8:30am-5pm Join to apply for the Physician Advisor role at Baptist Health. Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers across Miami-Dade, Monroe, Broward and Palm Beach counties. The organization is known for centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, supported by philanthropy and guided by a faith-based mission of medical excellence. Responsibilities
The Physician Advisor (PA) serves as a clinical resource to the medical staff and Case Management/Utilization (CM/SW) by identifying, facilitating and resolving utilization issues. Collaborates with admitting physicians, healthcare team and case management to proactively manage cases from entry through hospital stay to ensure appropriate level of care based on medical necessity, severity of illness and risk of mortality. Ensures CMS compliance for appropriate billing and conducts post-discharge reviews related to payer audits. Promotes understanding and cooperation between the medical staff through communication, collaboration and education. Facilitates improvements in clinical practice to achieve better performance, reduced length of stay, fewer readmissions, and superior patient care. Qualifications
Degrees: Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO). Licenses & Certifications: ABQAURP Physician Advisor Sub-Specialty Certification. Additional Qualifications: Certification as Physician Advisor by a national physician advisor organization or ABQAURP certification (or similar) must be obtained within one year of hire. Minimum 3 years of work experience as a practicing physician, with experience performing case reviews, and experience using MCG and/or InterQual criteria. Knowledge of CMS 2 Midnight Rule, Conditions of Participation, and inpatient billing requirements. Ability to analyze, organize and prioritize work while meeting deadlines; strong written and oral communication; ability to handle stressful situations with professional composure. Ability to understand and follow instructions; ability to exercise sound and independent judgment; proficiency with job-appropriate technology and software. Ongoing education in CMS guidelines, quality and utilization management through continuing medical education and self-study. Experience & Licensing
Minimum Required Experience: 3 years. Maintains active MD or DO license. If the license is not Florida, active Florida license must be obtained within one year of hire. ABQAURP certification (or equivalent) must be obtained within one year of hire. A minimum of 3 years of experience in case reviews and use of MCG/InterQual criteria is required. Equal Employment Opportunity
EOE, including disability/vets Note
All other content not essential to the job description has been removed to improve clarity and focus.
#J-18808-Ljbffr