Physician Advisor
Company: Community Medical Center
Location: Toms River
Posted on: June 19, 2022
Job Description:
Community Medical Center, an affiliate of RWJBarnabas Health, is
a 592-bed, fully accredited acute care hospital offering area
residents world-class medical treatment with the comforts of
hometown care. Opened in 1961, CMC has evolved into the state s
newest teaching hospital with three residency programs and Ocean
County s largest and most active health care facility caring for
over 21,500 inpatients, 178,000 outpatients and 73,700 emergency
department patients each year.The Physician Advisor is a physician
serving his/her/their assigned hospital through teaching,
consulting and advising both the Case Management department and the
hospital physicians and staff on matters regarding physician
practice patterns, documentation, over and under-utilization of
resources, medical necessity, compliance rules and regulations,
collaboration and relationships with payers and community. The
Physician Advisor is charged with meeting the organization's goals
and objectives for assuring the effective and efficient utilization
of health care services.Position Summary:
- Provide physician support and leadership to the utilization and
resource management areas of care management including
mentoring/coaching Utilization Review Coordinators/Care
Coordinators, reviewing cases for medical necessity and
collaborating with physicians, house staff, and hospitalists in
determining appropriate inpatient versus outpatient/observation
status.
- The physician advisor will educate residents, hospitalists, and
attending physicians in preventing denials and determining
appropriate levels of care for patients. He/she/they will also
identify and address issues related to throughput, efficiency,
length of stay, resource utilization, readmission avoidance,
quality, safety, and patient satisfaction primarily through the
performance of multi-disciplinary rounds.
- The physician advisor must form a collaborative partnership
with the hospital administration, the medical staff, and the case
management department leadership and staff. This partnership will
support a comprehensive clinical resource management program that
includes utilization management, progression of care management,
social work services, and complex discharge planning.
- The physician advisor will serve as a liaison between the
clinical documentation team and the medical staff. The PA will use
their clinical position to explain and educate the medical staff in
reference to the clinical documentation program (CDS). The
Physician advisor will also serve as medical director to the
Transitional Care Unit, a short term sub-acute within the
building.Education, Experience and Skills:
- Board Certified/Board Eligible and Valid New Jersey Medical
License
- Minimum of 5 years of Clinical Practice Experience
- Previous Utilization Management Experience in Acute Care
Setting strongly preferred
- Knowledge of CMS Regulations
- Knowledge of nationally accepted guidelines (MCG, InterQual)
preferred
- Excellent interpersonal and communication skills, ability to
influence and educate
- Strong organizational and computer skills
- Ability to multi-task and set prioritiesAt Community, our
employees make the difference, which is why we offer a
comprehensive benefit package that includes health, dental, vision,
disability insurance, and a 401(k)-retirement savings plan. To
encourage the advancement of our employees, we offer a tuition
assistance program and provide opportunities for professional
development and growth.Community Medical Center is dedicated to
advancing the quality of life and health of our community while
delivering compassionate care for our patients. Our core values
include: Compassion, Quality, Accountability, Integrity, Diversity
and Teamwork.Equal Opportunity Employer
Keywords: Community Medical Center, Brick , Physician Advisor, Healthcare , Toms River, New Jersey
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