Physician Advisor

Employer
SSM Health
Location
Lake Saint Louis, MO
Posted
Sep 03, 2020
Closes
Sep 03, 2021
Ref
2276
Specialty
Other Specialty
Are you an experienced doctor looking to make a career change away from direct patient care? Do you have experience creating relationships with payers and providers, making sure there is the best optimization of patient care?
The Physician Advisor role will support our Vice President of Medical Affairs at St. Joseph's Medical Center in St. Charles, MO and St. Joseph's Medical Center in Lake St. Louis, MO. This role will be split 50/50 between both locations.

The responsibilities and duties of the Physician Advisor shall include but not be limited to the following tasks:
  • Provide education and in-service instruction programs to train employees, physicians, and subcontractors who provide health care services
  • Assist Hospital administrations in developing and defining the clinical program and the scope of services of the program, which include but not limited to, assisting any Medical Staff committee in reviewing and revising applicable rules, regulations, or policies that pertain to the program.
  • Advise and consult with Hospitals, and act as a liaison to Medical Staff committees regarding developing, reviewing, and recommending policies and procedures concerning the general operation of the program.
  • Participate in Hospital's quality improvement programs including efforts to improve performance regarding CMS quality initiatives.
  • Participate, as reasonably requested, in special projects related to the program.
  • Assist Hospitals in meeting its fiscal goals through appropriate cost containment measures.

Physician Duties:
  • Reviews referred medical records and addresses the clinical theory of diagnosis for admission status, continued stay and in coordination of written appeal letters to payors.
  • Daily work with the denials/appeals team in concurrent chart review to assess denials and appropriate levels of care. This service would be coordinated through the Department of Care Coordination.
  • Daily concurrent chart review on an "as needed" basis by the Case Managers to review current treatment plans, identify unnecessary delays in care, and assist the case managers in facilitating care with the health center and functioning as a liaison to the attending physicians in order to provide the highest quality of care in the most efficient manner possible.
  • Participates in CDMP program, and addresses any cases referred by the Clinical Documentation Specialists.
  • Will be an active member of the Medical Staff Utilization Review Committee
  • Makes presentations to key physician(s) and other leadership groups.
  • Willing to learn documentation concepts and abide by clinical guidelines.
  • Stays abreast of changes to pertinent regulations.
  • Should be a well-respected member of the medical staff with broad clinical knowledge who will work in a collaborative team approach with physicians, CDS's, Case Managers, Coders, and Compliance staff. Should have general computer skills and learn to utilize the EPIC electronic health record.
  • Physician Advisor will continue to maintain at minimum courtesy privileges at one of the SSM Health Hospitals and maintain an active State of Missouri Medical License.


Education
  • D.O. or M.D. required
  • Valid MO medical license


Experience
  • Must have at least 3 years of clinical experience


Qualifications

Physician - State of Work Location