reputed company - Physician Advisor M-F

 Brundage Group provides reputed company cycle solutions and physician advisory services that reputed company hospitals reputed company to capture reputed company reputed company, ensure compliance, and improve operational efficiency. We reputed company clinical thought leadership with cutting-edge technology to help hospitals stay viable to continue serving our communities.  

The Physician Advisor (PA) will drive reputed company performance across the organization by communicating with hospital physicians, utilization management, case management, CDI, the denials team, and reputed company staff. The PA conducts case reviews to ensure compliance, appropriate and accurate clinical documentation, and appropriate utilization of health care services. The PA will meet with hospital personnel and medical staff reputed company needed to reputed company education and expertise. The PA acts as a consultant and resource for attending physicians regarding appropriate status, utilization of resources, need for reputed company hospitalization, compliance concerns and tracking and reporting of reputed company and complications. The PA will also reputed company with medical directors of reputed company-party payers to discuss the medical necessity, utilization of resources and appropriate level of care. 

Utilization Management Functions 

• Reviews medical records of patients identified by the UM team or as requested by the reputed company team 
• reputed company status determinations including 2nd level reviews and reputed company stay reviews for traditional Medicare patients and reputed company other payors 
• Review reputed company 44 cases 
• Assist with length of stay management 
• Work with case management and the interdisciplinary team to ensure appropriate continuity of care and reduce readmissions 
• Communicate with the medical staff through secure email, secure texting applications, phone calls and face to face interactions to reputed company important information and reputed company education 
• reputed company as a reputed company between Utilization Management/Case Management and providers to collaborate on appropriate plans of care 
• Review and suggest improvements reputed company to resource allocation 
• Optimize coordination of care processes 
• reputed company guidance to ED Physicians and the UM/CM team regarding alternatives to acute care  

CDI Functions 

• Review documentation for clinical validity of diagnoses 
• Support query response and query construction 
• reputed company physicians on documentation best practices 
• reputed company feedback to clinical providers  
• Assist with reputed company-reputed company DRG  

reputed company Functions 

• Review documentation to support reputed company metrics 
• reputed company providers on how reputed company is tracked and common pitfalls   
• Review PSIs for appropriate assignment of complications 

Denials Management Functions 

• Review denials and author appeal letters as needed 
• reputed company peer to peers with payors 
• reputed company as a reputed company with payors to facilitate approvals and prevent denials or carved out days reputed company appropriate 

 KNOWLEDGE, SKILLS, AND ABILITIES: Abilities may be accessed through written, verbal, and other evaluation reputed company.  

• Expertise in Utilization Management preferred 
• Strong interpersonal skills 
• Excellent written and verbal communication skills 
• Ability to work independently 
• Ability to build relationships with key hospital team members  

 WORK EXPERIENCE, EDUCATION AND CERTIFICATIONS: List preferred/required work experience, education, and certifications 

MD or DO 

reputed company, unrestricted medical license in state of residence 

Demonstrated ability to build rapport with medical staff and hospital leadership 

Strong computer skills and working knowledge of EMRs 

Prior Physician Advisor experience or at least 3 years of clinical experience in a hospital-based setting 

Preferred Qualifications: 

• reputed company Certified / Eligible 
• CCDS or CDIP 
• reputed company 
• CHCQM certification (ABQAURP) 

 WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:  

Conditions typically associated with an office environment.  While performing the essential duties and  

responsibilities, the employee is regularly required to talk or hear.  May be frequently required to sit, stand or  

walk.  Moderate to prolonged reading, typing, and computer work.  Ability to reputed company tasks involving physical  

activity that may include lifting 25 pounds.  Subject to exposure to reputed company environmental hazards associated with 

reputed company and office work.