Physician Advisor Opening with SSM Health
Lake Saint Louis, MO
- Provide education and in-service instruction programs to train employees, physicians, and subcontractors who provide health care services
- Assist Hospital administrations in developing and defining the clinical program and the scope of services of the program
- Advise and consult with Hospitals, and act as a liaison to Medical Staff committees regarding developing, reviewing, and recommending policies and procedures concerning the general operation of the program.
- Participate in Hospital's quality improvement programs including efforts to improve performance regarding CMS quality initiatives.
- Participate, as reasonably requested, in special projects related to the program.
- Assist Hospitals in meeting its fiscal goals through appropriate cost containment measures.
- Reviews referred medical records and addresses the clinical theory of diagnosis for admission status, continued stay and in coordination of written appeal letters to payors.
- Daily work with the denials/appeals team in concurrent chart review to assess denials and appropriate levels of care. This service would be coordinated through the Department of Care Coordination.
- Daily concurrent chart review on an "as needed" basis by the Case Managers to review current treatment plans, identify unnecessary delays in care, and assist the case managers in facilitating care with the health center and functioning as a liaison to the attending physicians in order to provide the highest quality of care in the most efficient manner possible.
- Should be a well-respected member of the medical staff with broad clinical knowledge who will work in a collaborative team approach
- Physician Advisor will continue to maintain at minimum courtesy privileges at one of the SSM Health Hospitals and maintain an active State of Missouri Medical License.
Posted June 26, 2020