On-site Physician Advisor Position in Williamsburg, VA Coastal Virginia Peninsula
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Job Location:
Williamsburg, VA - USA
Monthly Salary:
$ 93600 - 312000
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
City/State
Williamsburg VAWork Shift
First (Days)Overview:
The Physician Advisor conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and completing peer to peers writing appeal letters) in support of the centralized system Utilization Review (UR) process for Sentara hospital facilities. The Physician Advisor serves an important role in ensuring compliant hospital status/billing for hospital patients and strengthening relationships between Clinical Revenue Cycle UR hospital leadership medical staff and hospital ICM. The Physician Advisor interfaces directly with the medical staff providing concurrent communication and education to attending physicians (and their APCs) regarding recommended changes in hospital status pertinent regulatory requirements and guidance impacting the determination as well as documentation integrity to support medical necessity of services being delivered.
As this roles duties include significant interpersonal and relational aspects in addition to regulatory training and licensing requirements an active and unrestricted Virginia medical license and board-certified status at the time of hire are required as well as superb interpersonal and communication skills. Due to the collaborative and highly relational nature of this role on-site (in person) presence is integral. Coverage at additional sites may be required including occasional in-person responsibilities. The position reports to the Director of Regional Physician Advisors to Clinical Revenue Cycle.
- Perform timely and compliant medical necessity reviews providing clear documentation of the pertinent details of the case to satisfy regulatory requirements and directly communicating any necessary
- Facilitate denials management through review of selected cases conducting peer to peer discussion with third party payers as appropriate and assisting with appeals letters
- Work closely with hospital leadership medical staff and hospital ICM leaders to support system CPIs and initiatives
- Attend and participate in Hospital UM committees at designated sites
- Complete training and continuing education as deemed necessary
- Attend and participate in educational presentations to medical staff administration leadership and peers
- Additional functions as deemed appropriate and warranted
Minimum Requirements:
- Completion of Medical doctorate or Doctor of Osteopathy degree from an accredited medical school
- Completion of an accredited residency training program
- Minimum of 3 years of clinical experience hospital clinical experience strongly preferred
- Active and unrestricted state Virginia medical license
- Board certification in specialty required at time of hire
- Possess or acquire a working knowledge of CMS regulatory guidance and requirements as they pertain to UR and site of service decisions
- Possess a working knowledge of clinical documentation integrity hospital billing and coding processes and guidelines case mix index and DRG assignments
- Familiarity with standard published leveling criteria such as MCG/Interqual and ability to apply professional judgment and patient specificvariables as may be necessary or justifiable
- Familiarity with (Hospital) organization and case management operations
- Excellent customer service and interpersonal skills.
- Able to effectively present information both formal and informal
- Superb written and verbal communications skills
- Ability to set and manage priorities
- Demonstrate flexibility teamwork and a collaborative leadership style
- Strongtechnical/computer skills and working knowledge of the systems EMR
#indeed
We provide market-competitive compensation packages inclusive of base pay incentives and benefits. The base pay rate for Full Time employment is:$93600.00-$312000.00. Additional compensation may be available for this role such as shift differentials standby/on-call overtime premiums extra shift incentives or bonus opportunities.Sentara Williamsburg Regional Medical Center a Certified Primary Stroke Center has 145 licensed beds and features the latest healthcare technologies serving the region with the life-saving capabilities of an ultra-modern medical center.
The hospital offers a full range of medical care from emergency heart catheterization to all-inclusive obstetrics care where patients can stay in one room. The hospital also provides advanced imaging and smart operating rooms. Sentara Williamsburg Regional Medical Center has also achieved Magnet recognition the nations highest honor for excellence in nursing. We improve health every day come be a part of the community.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30000-member workforce. Diversity inclusion and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission to improve health every day this is a tobacco-free environment.
For positions that are available as remote work Sentara Health employs associates in the following states:
Alabama Delaware Florida Georgia Idaho Indiana Kansas Louisiana Maine Maryland Minnesota Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Pennsylvania South Carolina South Dakota Tennessee Texas Utah Virginia Washington West Virginia Wisconsin and Wyoming.
Required Experience:
Unclear Seniority
Key Skills
- EMR Systems
- Post Residency Experience
- Occupational Health Experience
- Pain Management
- SOAP
- Primary Care Experience
- Medical Management
- Suturing
- Workers' Compensation Law
- Pharmacy Residency
- Botox Experience
- Epic
About Company
Sentara Health, is an integrated, not-for-profit health care delivery system in Virginia and North Carolina. Sentara improves health everyday.
