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Physician Advisor

Company: Community Medical Center
Location: Toms River
Posted on: August 4, 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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