Internist Job at University Hospitals in Cleveland, OH

Physician Advisor

The Physician Advisor (PA) team for relative duties report to the System PA Lead and support the PA program for UH. The PA help to create and update formal training and education programs for UH providers helping to hardwire and sustain adherence to documentation requirements reflecting appropriate level of care, care setting, and clinical documentation that accurately reflects patient severity of illness, risk of mortality and appropriate reimbursement for hospital services. The PA provides support to the care team ensuring medical Staff, leadership, resource management and all patient care support teams to conduct clinical reviews on cases in accordance with hospitals objectives and policies for assuring quality patient care and effective, efficient utilization of health care services, and to meet regulatory requirements.

The PA meets with UM and the health care team member to discuss selected cases and make recommendations for level of care. The PA interacts with medical staff, leaders, third party payers to discuss needs of patients and alternative level of care. The PA acts as a consultant resource to attending physicians regarding their decisions relative to appropriateness of hospitalization, continued stay, use of resources and comprehensive and accurate clinical documentation. He or she acts as a resource to medical staff regarding federal and state utilization and quality regulations as well as compliant documentation and coding to support technical billing and reimbursement.

Through collaboration with all members of the health care and business teams, patient and family, to coordinate timely, effective and efficient delivery of required patient information and services to result in:

• Positive patient/family, provider and team experience and satisfaction

• Timely and accurate capture of information in compliance with governmental and 3rd party agencies that supports appropriate reimbursement and collection of expected payment for services provided.

• Improved efficiency and standardization of services, service and performance metrics

• Improved service delivery in every care setting; inpatient throughput from admission to discharge

• Model strong relationships with provider and clinical staff along with associated leadership and staff alike to support open collaboration and breakdown barriers to establishing joint workflow and policies with other departments/areas to influence decreased denials and appropriate reimbursement.

Qualifications

Education:

M.D. required

Required Credentials, License, and/or Certifications:

Member of the American College of Physician Advisors (ACPA) preferred.

Experience and Knowledge:

• Experience as a Hospitalist strongly preferred
• Possesses a solid foundation, knowledge, and/or experience in the areas of utilization management, clinical documentation integrity, quality improvement, patient safety, and hospital operations.
• Strong computer skills and working knowledge of the EMR.
• Familiarity with MCG and Interqual placement status criteria is preferred.
• Familiarity with ICD-10 coding guidelines and requirements for compliant documentation and coding of inpatient encounters.
• Ability to build rapport with medical staff and hospital leadership to obtain the buy-in and collaboration necessary to achieve desired outcomes
• Functions as a key member of the leadership team with responsibility for encouraging creative use of technology in support of the business needs of the organization
• Experience partnering with operational and administrative departments to address performance improvement and/or quality strategies
• Ability and experience dealing with healthcare and medical staff
• Outstanding verbal, written communication and presentation skills
• Excellent analytical, problem solving and organizational skills