MedStar Health
Physician Advisor - MedStar Washington Hospital Center
MedStar Health, Washington, District of Columbia, us, 20022
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About The Job MedStar Health is seeking a Physician Advisor to join our team at MedStar Washington Hospital Center in Washington DC. The Physician Advisor is an essential part of the team, using medical expertise to optimize resource use, reduce length of stay, and prevent clinical denials. Their work ensures patients receive appropriate, timely care. This will be a hybrid role.
In This Role, You’ll
Review patient status, medical necessity, and level of care
Lead clinical denial interventions, denial root cause determinations and upstream process improvement initiatives.
Engage in concurrent and retrospective denials management and peer to peer discussions with payers
Drive length of stay improvements in close collaboration with case management and hospital stakeholders
Provide education to physicians and other clinicians related to regulatory requirements, appropriate utilization of hospital services, community resources, and alternative level of care
Participate in Interdisciplinary Rounds (IDR) with the Healthcare Team as indicated.
Ensure regulatory compliance of Utilization Management and Discharge planning processes
At MedStar Health, You Can Expect
A competitive salary
Medical, dental, and vision insurance
Paid malpractice insurance
Paid Time Off
Retirement plan
Education/Training
Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) - Board Certification required (Internal Medicine or Emergency Medicine preferred)
Preferred: Additional certification in healthcare administration, business, or physician advisory
Experience
Minimum 5 years of direct clinical practice required, hospital based experience preferred
Previous experience as physician advisor preferred
Strong knowledge of case management, utilization review, regulatory standards, denials management, observation medicine, and length of stay
Familiarity with MCG and InterQual clinical criteria
Licensure/Certification
Current medical license in the practicing state
Board Certified
Preferred: ACPA-C or ABQUARP certification in Physician Advisory (or willingness to obtain within 1 year of hire)
This position has a hiring range USD $250,000.00 - USD $350,000.00 /Yr.
Seniority level Not Applicable
Employment type Full-time
Job function Health Care Provider
Industries Hospitals and Health Care
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About The Job MedStar Health is seeking a Physician Advisor to join our team at MedStar Washington Hospital Center in Washington DC. The Physician Advisor is an essential part of the team, using medical expertise to optimize resource use, reduce length of stay, and prevent clinical denials. Their work ensures patients receive appropriate, timely care. This will be a hybrid role.
In This Role, You’ll
Review patient status, medical necessity, and level of care
Lead clinical denial interventions, denial root cause determinations and upstream process improvement initiatives.
Engage in concurrent and retrospective denials management and peer to peer discussions with payers
Drive length of stay improvements in close collaboration with case management and hospital stakeholders
Provide education to physicians and other clinicians related to regulatory requirements, appropriate utilization of hospital services, community resources, and alternative level of care
Participate in Interdisciplinary Rounds (IDR) with the Healthcare Team as indicated.
Ensure regulatory compliance of Utilization Management and Discharge planning processes
At MedStar Health, You Can Expect
A competitive salary
Medical, dental, and vision insurance
Paid malpractice insurance
Paid Time Off
Retirement plan
Education/Training
Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) - Board Certification required (Internal Medicine or Emergency Medicine preferred)
Preferred: Additional certification in healthcare administration, business, or physician advisory
Experience
Minimum 5 years of direct clinical practice required, hospital based experience preferred
Previous experience as physician advisor preferred
Strong knowledge of case management, utilization review, regulatory standards, denials management, observation medicine, and length of stay
Familiarity with MCG and InterQual clinical criteria
Licensure/Certification
Current medical license in the practicing state
Board Certified
Preferred: ACPA-C or ABQUARP certification in Physician Advisory (or willingness to obtain within 1 year of hire)
This position has a hiring range USD $250,000.00 - USD $350,000.00 /Yr.
Seniority level Not Applicable
Employment type Full-time
Job function Health Care Provider
Industries Hospitals and Health Care
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