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Per Diem Physician Advisor / Clinical Resource Management

Employer
Hartford HealthCare Medical Group
Location
Wethersfield, Connecticut
Closing date
Oct 6, 2023

View more

Specialty
Other Specialty
Hours
Per Diem

Job Details

Description
Job Schedule: Per Diem
Standard Hours: .025
Job Shift: Shift 1
Shift Details:

Per Diem Opportunity for a Physician Advisor - Clinical Resource Management

Every day, over 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.
With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Department Description:

Integrated Care Partners (ICP) is a physician-led, clinically integrated health care network whose mission is to assist our members in providing the highest quality care at the most reasonable cost for our patients in the current, rapidly changing medical environment.

Position Summary:

The Physician Advisor is an integral member of the Clinical Resource Management Team who partners closely with the Clinical Resource Management Nurse to evaluate the resources expended to care for our patients and ensure they are appropriate to the clinical needs of the patient and are being delivered in the least invasive, least restrictive and least costly environment. The Physician Advisor ensures the highest quality patient care while maintaining fiscal stewardship for HHC as well as regulatory compliance. Holiday and weekend coverage will be required.

Position Responsibilities:
  • Review cases identified in need of second level physician review for level of care determinations and appropriate utilization of resources.
  • Respond promptly to requests for second level physician review by the Clinical Resource Management Nurse.
  • Communicate directly with attending physicians on level of care discrepancies, over-utilization and under-utilization of resources to affect resolution.
  • Intervene as needed with payers for peer to peer negotiation and appeal/denial support.
  • Develop and maintain expertise of regulatory guidelines regarding utilization review activities and utilization standards and trends.
  • Provide education to physician colleagues on utilization standards and trends.
  • Adhere to minimum Physician Advisor shift coverage requirements, including weekends and holidays.
  • Other duties as assigned.

  • Reports To: Medical Director of Clinical Resource Management

    Qualifications
    Education: Doctor of Medicine or Doctor of Osteopathic Medicine

    Experience: Three to five years of acute experience. Five years of relevant experience, acute care or managed care is preferred.

    Licensure, Certification, Registration: Valid State of CT Physician License

    Knowledge, Skills and Ability Requirements:
    • Able to influence, negotiate and educate
    • Ability to understand and interpret patient data, finance and utilization reports
    • Understanding of government and payer coverage criteria and regulatory requirements

    We take great care of careers.

    With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge - helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

    Company

    About Hartford HealthCare

    The Hartford HealthCare network employs over 2,500 providers in over 400 practice locations throughout Connecticut, 7 acute care hospitals including one of the largest academic and surgical hospitals in the northeast, thriving community teaching hospitals, one of the largest behavioral health networks and one of the largest, physician-led, multi-specialty medical groups in New England.

    This means MORE OPTIONS to propel careers to new heights and all within a deeply embedded culture of inclusion, innovation, and focus on the highest quality of care. We are teachers, researchers, leaders and, most of all, caregivers.

    Our location: Connecticut is located within two hours of Boston and New York City and offers access to the finest schools in the nation, four beautiful seasons of recreational activities, access to New England beaches and ski resorts, and options to live near the shore, in leafy suburbs, or in vibrant urban areas.

    Company info
    Website
    Telephone
    860-558-6591
    Location
    1290 Silas Deane Highway
    2nd Floor
    Wethersfield
    Connecticut
    06109
    US

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