Physician Advisor - St George, Utah
- Employer
- Intermountain Health
- Location
- St George, Utah
- Posted Date
- Apr 20, 2021
- Reference
- R13875
Job Details
This Physician Advisor will provide utilization reviewer and central appeals work services. Physician shall engage, educate, and coach physicians and other clinicians in appropriate documentation of medical necessity for hospital admissions and other diagnostic and therapeutic interventions.
Physician shall work in partnership with the utilization review committee to ensure procedures are in place to follow all rules and regulations and maintain compliance. Physician shall serve as an expert and local resource to hospital Case Management Department and Medical Staff on issues relating to clinical documentation and medical necessity. In addition, Physician shall work closely with Medical Directors, Nursing Administrators, Case Management Directors, and Finance Director.
Job Essentials
- Work with and support the Case Management Department to ensure appropriate admission and discharge status and timing.
- Be a consistent resource for physicians and case managers on issues relating to clinical documentation, appropriate admission status, and patient flow.
- Provide oversight and coordination of physician education and coaching on regulatory issues.
- Participate and provide physician expertise for appeals in coordination with R1 Central Appeals Unit (“CAU”).
- Attend System Utilization Review (“UR”) Committee and provide Regional Physician Advisor Educators information to be shared at Regional UR Committees as assigned.
- Perform high level utilization review on a population basis to help guide compliance and educational efforts.
- Work with other IHCHS Physician Advisors and provide service to other regions as needed.
- Work under direct supervision of the IHCHS Chief Patient Experience Officer and IHCHS System Physician Advisor.
- Participate in other IHCHS meetings as needed.
- Add Utilization Review shifts as directed by System Physician Advisor.
- Oversee Intermountain Physician Advisor Services (“IPAS”) Utilization Review physicians and nurses in conjunction with System Physician Advisor.
- Coordinate Tertiary Review schedule and completion. Physician will need to arrange for another IPAS physician to be on-call as the second IPAS reviewer for those cases where Physician is the original IPAS reviewer and a second IPAS reviewer is required.
- Obtain and distribute pertinent UR data to IPAS UR team and IHCHS leadership as appropriate.
- Oversee IPAS UR physicians and nurses to arrange monthly meetings, agendas, schedule and ad hoc education in conjunction with System Physician Advisor.
- Work with System Utilization Review Manager and others to adjust UR workflow to reflect current trends and documentation requirements.
- Give feedback to IPAS UR physicians and Case Management regarding denials to enable adjustments to front-end practice.
Minimum Requirements:
- Medical Doctor or Doctor of Osteopathic Medicine Degree. Education must be obtained through an ACGME or AOA accredited institution. Degree will be verified.
- ABMS or equivalent AOA Board Certification
- Active Utah or Idaho Medical Licensure, or in process of obtaining licensure.
- Two years of experience leading successful improvements in clinical settings.
- Experience with change management with the ability to provide leadership in the adaptation and implementation of new processes or technology that enhance safety.
- Effective verbal, written, and interpersonal communication skills.
Physical Requirements:
- Interact with others requiring employee to verbally communicate as well as hear and understand spoken information.
- Operate computers, telephones, office equipment, and manipulate paper requiring the ability to move fingers and hands.
- See and read computer monitors and documents.
- Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.
- Preferred Qualifications:
- Trained in improvement science (i.e., Six Sigma, Lean, Project management, Advanced Training Program).
- Experience working in a complex health system (e.g., hospitals, ambulatory clinics, post-acute care).
- Demonstrated leadership of clinicians.
Physical Requirements:
Location:
St George Regional Hospital
Work City:
St George
Work State:
Utah
Scheduled Weekly Hours:
10
Company
As the largest nonprofit health system in the Mountain West, Intermountain Health is dedicated to creating healthier communities and helping our patients and physicians thrive.
It’s time to think of health in a whole new way, and by partnering with our patients and communities, providing expert care closer to home, and making great health more affordable, we can help more people get and stay well. We proudly invest back into improving the care we deliver, and our pioneering research is making healthcare more personalized, effective, and affordable.
Serving patients and communities throughout the Mountain West, primarily in Colorado, Utah, Montana, Nevada, Idaho, Kansas, and Wyoming, Intermountain includes 33 hospitals, 300+ clinics, a medical group, affiliate networks, homecare, telehealth, health insurance plans, and other services - along with wholly owned subsidiaries including Select Health, Castell, Tellica Imaging, and Classic Air Medical.
Our Caregiver Promise: Together, for the healthiest lives
We celebrate the different perspectives, backgrounds, experiences, and identities our physicians bring to their work every day at Intermountain. Across all areas of our integrated health system, we proudly share best practices, knowledge, and techniques to better serve our patients, communities, and each other.
Here, you’ll work alongside collaborative and curious minds who will support you, encourage you, inspire you, advocate for you, and challenge you to be your very best.
Our Values
Our value statements are core to our culture. They reflect the behavior and attitudes that are important to us, are an agreement for how we treat each other, help us make decisions on how to act, and are a promise of what people can expect from us.
Our action-oriented values, inspired and shaped by our own physicians and caregivers, speak to what it means to be part of Intermountain.
- We are leaders in clinical excellence, delivering safe, best-in-quality care
- We believe in what we do, living our mission every day
- We serve with empathy, caring for each caregiver, patient, and member with compassion and respect
- We are partners in health, collaborating to keep people well
- We do the right thing, learning and acting with purpose
- We are better together, building community through teamwork and belonging
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