Physician Advisor Opportunity
- Position Type
St. Joseph's Health has an excellent employment opportunity for a Physician Advisor – Case Management within the St Joseph’s Health hospital located in Syracuse, New York.
The Lead Physician Advisor will evaluate hospitalized patient needs with resources to meet quality, clinical, and regulatory standards. The Lead Physician Advisor assists with performing Utilization Management level of care chart reviews and provides clinical perspective on case management questions. Additionally, this provider will provide oversight of protocols, standard work and schedules for improvement, perform chart reviews for Hospital Acquired Conditions and Patient Safety Indicators, as well as collaborate on other tasks related to improving patient provider documentation as appropriate.
Responsibilities for this opportunity include:
- Conduct level of care reviews not meeting criteria by nurse reviews; review with providers when a level of care change is suggested
- Evaluate complex and discharge issues, continued stay medical necessity and delay in service delivery concerns
- Provide advice and education regarding provider utilization questions
- Readmission review for assessment of claim modification
- Payer denial and audit review for medical necessity and necessary appeals
- Pre-claim reviews for high audit medical necessity risk areas
- Chart reviews for Hospital Acquired Conditions, Patient Safety Indicators, and provider documentation deficiencies
- Observation list review and assessment for transfer to inpatient level of care
- Assess Medical Surgical outliers for certification of medical necessity
- Assist with development of Physician Advisor schedules, meetings, protocols for reviews, standard work
- Education to providers and hospital staff in collaboration with the Manager of Case Management
- Work with Director of Transition Care assisting with Utilization Management Advisory Committee agendas, goals
- Interdepartmental work with Regulatory Review and Analysis, Revenue Cycle Management, Health Information
- Management (Coding, CDI), and Revenue Integrity in collaboration with the Medical Director of Case Management
- Be available for development of payer contracts, internal policy development related to medical necessity
- Implementation of new processes related to updated regulations, leadership requests, and medical staff needs
Qualifications for this opportunity include:
- MD or DO with clinical experience
- Current New York state medical license
- Minimum of two years’ experience in utilization management
- Experience using an electronic health record
- Clinical leadership and clinical systems workflow
- Strong broad based clinical knowledge
St. Joseph's Health offers a comprehensive salary and benefit package.
ABOUT THE FACILITY
St. Joseph's Physicians is an affiliate of St. Joseph's Hospital Health Center. As the leading comprehensive medical practice in Central New York, St. Joseph's Physicians is evolving as a role model for excellence in primary care delivery across the region.
St. Joseph's Physicians consists of seamlessly integrated practice areas and complementary ancillary services with convenient locations across Central New York. As our practices grow, we remain committed our mission where patients can access advanced health care services and the expertise of specialists right in their own neighborhoods and communities.
Committed to advancing the "medical home," St. Joseph's Physicians is an NCQA certified Patient Centered Medical Home. Our integrated approach links the physician with the St. Joseph's system of services to ensure that our patients receive the highest quality of medical care—all under one system. The "broader system" is the full spectrum of care from the primary physician's office, to the specialist's office, to the hospital and its associated services.
We have always viewed the delivery of quality, accessible healthcare to be our mission. With more than 70 providers and mid-level practitioners and over 600 employees dedicated to the delivery of quality, accessible healthcare to Syracuse-area residents. On a typical day, St. Joseph's Physicians sees approximately 1,200 patients. Most of these patients will be able to address many of their medical needs without ever leaving our offices.
St. Joseph’s Health is a non-profit regional health care system based in Syracuse, NY, providing services to patients throughout Central New York and northern Pennsylvania. From primary to specialty to home care, to our Magnet-recognized hospital, and in collaboration with our community partners, St. Joseph’s is advancing the health of the communities we serve through an expanding range of services to ensure our patients achieve optimum health. Ranked by Consumer Reports among the top 15 heart surgery centers in the country, U.S. News “Best Regional Hospital” and a 15-time winner of the National Research Corporation Consumer Choice award, St. Joseph’s is widely recognized for quality, value and delivering the highest patient satisfaction.
St. Joseph's Health is affiliated with St. Joseph's Physicians and .is part of Trinity Health one of the largest Catholic health care organizations in the United States. Trinity Health is based in Livonia, Michigan, a Catholic national health care system located in Livonia, Michigan.
Syracuse, New York is located in the center of New York State.
Education, Convenience and Housing are the major benefits of life in Syracuse. Several top rated public educational schools in places like Fayetteville Manlius and Jamesville Dewitt are under 20 minutes away. When you would like to get away for the weekend, an easy drive four hours or so will have you in New York City or Toronto, Canada. Syracuse is also a short trip to the Finger Lake Wineries. What sets the Syracuse real estate market apart from most other major cities in New York State is its level of affordability.
St Joseph’s Health is less than 10 minutes away from the Syracuse Hancock International Airport. Syracuse's top employers are primarily in higher education, research, health care, and services; some high-tech manufacturing remains. University Hill is Syracuse's fastest growing neighborhood, fueled by expansions by Syracuse University and Upstate Medical University (a division of the State University of New York), as well as dozens of small medical office complexes.
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