Job details

Physician Advisor

Get a free resume review

Overview

Since 1885, CHI St. Alexius Health has been dedicated to leading health care in this region by enriching the lives of patients through the highest quality of care. We seek to continue our tradition of success and innovation with individuals dedicated to delivering the highest level of expertise and quality. Together we can continue to grow and support the legacy of CHI St. Alexius Health for many years to come.

CHI St. Alexius Health is a regional health network with a tertiary hospital in Bismarck, the system also consists of critical access hospitals (CAHs) in Carrington, Dickinson, Devils Lake, Garrison, Turtle Lake, Washburn and Williston and numerous clinics and outpatient services. CHI St. Alexius Health manages four CAHs in North Dakota - Elgin, Linton, and Wishek, as well as Mobridge Regional Medical Center in Mobridge, S.D. CHI St. Alexius Health offers a comprehensive line of inpatient and outpatient medical services, including: a Level II Trauma Center, primary and specialty physician clinics, home health and hospice services, durable medical equipment services, a fitness and human performance center and ancillary services throughout western and central North Dakota.

CHI St. Alexius Health is part of CommonSpirit Health, a nonprofit, Catholic health system dedicated to advancing health for all people. It was created in February 2019 through the alignment of Catholic Health Initiatives and Dignity Health. CommonSpirit Health is committed to creating healthier communities, delivering exceptional patient care, and ensuring every person has access to quality health care.

CHI St. Alexius also provides you with the quality care you provide to others. We care about our employees well-being and offer benefits that complement work/life balance.

We offer the following benefits to support you and your family:

Care@Work program supporting any child care, pet care, or adult dependent needs
Employee Assistance Program (EAP) for you and your family
Health/Dental/Vision Insurance
Flexible spending accounts
Voluntary Protection: Group Accident, Critical Illness, and Identity Theft
Adoption Assistance
Paid Time Off (PTO)
Tuition Assistance for career growth and development
Matching Retirement Programs
Wellness Program

Responsibilities

CHI St. Alexius is looking for a Physcian Advisor to join the team!

The Onsite Physician Advisor (PA) will serve as a physician leader and advocate for the improvement of a hospital’s utilization management, regulatory compliance, quality assurance, revenue integrity, and risk management. The Onsite PA will work in conjunction with the Care Coordination team to address areas of high importance and/or concern in the appropriate, effective, and efficient movement of a patient through their hospital encounter (e.g. accurate level of care determination, extended length of stay, appropriate discharge planning). As a respected member of the Medical Staff, the Onsite PA will participate in, if not Chair, the UM Committee, in addition to other key hospital committees (e.g. CDI, QA). They will also serve as a resource for, and consultant to, UM staff and attending physicians regarding decisions relative to appropriateness of hospitalization and level of care, clinical documentation, extended stays, avoidable days, readmissions, and use of healthcare resources. The PA will be a resource for the UM and Medical Staff regarding federal and state utilization and quality regulations, as well as, help to facilitate training and education sessions.

What You'll Do:

Provide leadership and oversight of facility-based physician advisory services.
Understand the intricacies of ICD-9-CM, ICD-10-CM/PCS, MS-DRG, APR-DRG, and the Medicare Inpatient Prospective Payment System (IPPS) to make medical determinations based on severity of illness, acuity, and risk of morbidity/mortality.
Review clinical record for medical necessity of acute hospital-based care on admission (as needed-e.g. condition code 44), as well as, throughout the hospital encounter; identifying appropriate opportunities for discharge planning and quality improvement.
Communicate, as appropriate, medical necessity assessments with treating physicians in cooperation with the utilization team and health information personnel.

Attend, participate and/or chair in facility-based:
Extended Length of Stay (LOS) Rounds
Multidisciplinary Rounds
Utilization Review Committee Meetings
Clinical Documentation Improvement (CDI) Committee Meetings
Quality improvement and safety committee
Collaborate with Care Coordination to assist in management of extended LOS encounters, specialty cases, and high-risk cases, in addition to serving as a resource for process improvement.
Maintain UM committee membership and support
Champion/advocate and support CDI, regulatory compliance, and improved utilization of hospital resources.
Support Revenue Integrity through assistance with Denial Prevention, Denial Management (e.g. Peer to Peer Review with payors when appropriate) and Regulatory Compliance.
Champion, collaborate and support Quality Assurance, and Risk Management in the facility .
Provide routine education and guidance to UM, Medical Staff and residents on regulatory, quality, and/or cost of care opportunities thereby supporting value based care initiatives.
Bridge communication between Care Coordination team and Medical Staff
Track, trend, and analyze -decided upon-performance and process improvement metrics for facility, UM/Medical Staff, and Physician Advisor program.
Communicate facility feedback and metrics to Executive leadership (i.e. CMO, Care Management Directors, Quality Directors etc.)
Serve as a liaison between the National Care Coordination and Physician Advisor teams with the facility-based Care Coordination teams, Medical Staff, and Executive Leaders.

Qualifications

Required Education:

Graduate of an accredited medical school

Required Licensure and Certifications:

MD or DO licensure within the state of employment

Required Minimum Knowledge, Skills and Abilities

Board Eligible in the area of clinical practice.

Preferred Qualifications:

Board Certification in area of clinical practice (ABMS)

Minimum of five years of clinical practice experience.

Three years of experience as a Physician Advisor and/or other leadership experience in acute care settings with focus on utilization management and quality assurance and improvement.

Utilization management experience as chair or as a member of an UM oversight committee.

Leadership involvement and/or management experience of quality ssurance.

Management experience in care efficiency and throughput in acute care hospital settings.

What You Should Know About Physician Advisor, UNAVAILABLE

Are you ready to take your medical career to the next level? Join the dedicated team at CHI St. Alexius Health in Bismarck as a Physician Advisor! This role is a fantastic opportunity for an experienced medical professional who is passionate about improving patient care and enhancing hospital operations. At CHI St. Alexius Health, where commitment to the highest quality of patient care shines since 1885, you'll serve as a physician leader, advocating for high standards in utilization management, compliance, and quality assurance. You’ll collaborate with the Care Coordination team to ensure effective patient movement through their hospital encounter, focusing on needed improvements and efficient discharge planning. This critical position involves participating in various committees to review and enhance medical practices and documentation standards. You’ll also provide guidance regarding federal and state quality regulations and facilitate valuable training sessions. With your leadership, we can promote quality assurance and risk management while supporting the wider community, as part of the CommonSpirit Health family. Plus, we care for the well-being of our employees, offering a wide range of benefits including flexible spending accounts, tuition assistance for career growth, and paid time off. If you have an MD or DO license and a passion for improving healthcare, come grow with us at CHI St. Alexius Health!

Frequently Asked Questions (FAQs) for Physician Advisor Role at UNAVAILABLE

What are the main responsibilities of the Physician Advisor at CHI St. Alexius Health?

The Physician Advisor at CHI St. Alexius Health is responsible for leading hospital utilization management efforts, ensuring regulatory compliance, and advocating for quality assurance practices. This role involves reviewing clinical records for medical necessity, participating in key hospital committees, and collaborating closely with the Care Coordination team for better patient management from admission to discharge.