Physician Advisor

Recruiter Contact Information: Samantha Wallace samantha.wallace2@christushealth.org CHRISTUS Health St. Elizabeth is seeking a full time, in-person Physician Advisor to join the team in Beaumont, TX! Roles and Responsibilities Overview The Physician Advisor is an administrative physician role serving CHRISTUS St. Elizabeth hospital and its affiliates through teaching, consulting, and advising both the Care Management Department and the medical staff on matters regarding physician practice patterns, documentation, resource utilization, medical necessity, compliance, payer relationships, and community engagement. The PA ensures physician support for Care Management and CDI initiatives by promoting effective documentation to support patient Level of Care, billing, and MS-DRG assignment. The PA will maintain monthly records of time spent on responsibilities. This is a Monday-Friday role with no call duties. Location: On Site - Beaumont, TX Reporting Relationship The PA reports directly to the Chief Medical Officer of CHRISTUS St. Elizabeth hospital. Professional Qualifications The Physician Advisor role requires: 5+ years of clinical experience Licensed physician in the state of residence Board certification in a clinical specialty Preferred: Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP) Experience in clinical practice and utilization review Participation in or leadership of a Utilization Management Committee Demonstrated cost-efficient practice Physician Advisor - Care Management & CDI Duties and Responsibilities Utilization Management (20%) Lead the Utilization Review Committee in collaboration with the Director of CM Conduct secondary reviews for appropriate care levels Perform peer-to-peer consults with payor medical directors for denied cases Monitor UM metrics and participate in improvement actions Physician & Staff Education (15%) Educate physicians and clinicians on regulatory requirements, billing, and utilization of care resources Facilitate referrals and payer requirements Mentor UR Case Managers Promote understanding of clinical documentation programs Care Management (50%) Participate in daily IDRs to expedite testing and treatment Guide ED physicians and CM staff on LOC designation Coordinate with payers for approvals and denials Review long-stay cases and hospital notices of non-coverage Document reviews and decisions as per hospital policy Basic knowledge of InterQual and MCG criteria Attend leadership and staff meetings for departmental goals Address conflicts of interest in patient reviews Clinical Documentation Integrity (15%) Assist with CDI queries Partner with CDI leadership for staff education Provide feedback to physicians on documentation Highlights/Benefits: Balanced professional and personal lifestyle Competitive compensation and benefits No state income tax Relocation assistance Community Description: Easy drive to Houston Lush countryside, pine-covered hills, lakes Year-round outdoor activities: golf, hunting, fishing, camping, hiking, boating Excellent schools EEO is the law - more info: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf We are committed to accessibility. Contact us at (844) 257-6925 for assistance or accessibility concerns.

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