BowlingGreenRecruiter Since 2001
the smart solution for Bowling Green jobs

Onsite Physician Advisor Bowling Green KY (Physician #)

Company: Optum
Location: Bowling Green
Posted on: August 10, 2019

Job Description:

Expanding access to affordable, high quality healthcare starts here. This is where some of the most innovative ideas in healthcare are created every day. This is where bold people with big ideas are writing the next chapter in healthcare. You'll have the most opportunities to grow and develop! This is the place to do your life's best work.(sm)

This position is for qualified physicians seeking to enter the new and growing non-clinical practice specialty of Physician Advisor with a career trajectory towards a provider or payor medical director and beyond. This position drives performance across our organization by communicating with hospital physicians and utilization management staff at client hospitals to champion best practices for evidence-based care and its documentation. The Physician Advisor will be responsible for establishing, maintaining, and strengthening the relationship with EHR client hospitals to appropriately optimize the use of EHR services.

Training will be provided by Optum. The Physician Advisor will join a team of on-site physician advisors across the country.

Primary Scope of Service:

Although the Physician Advisor (PA) is employed by Optum, the intention is that the PA will become a key member of the client hospital's leadership team charged with meeting the organization's goals and objectives for ensuring the effective, efficient utilization of health care services. To this end, the PA will develop expertise on matters regarding physician practice patterns, over- and under-utilization of resources, medical necessity, documentation best practices, level of care progression, denial management, and compliance with governmental regulations and commercial insurance contracts.

The Physician Advisor will work closely with the medical staff, including house staff, hospital leadership, and all utilization management (UM) personnel to develop and implement methods to optimize the use of hospital services. This includes care management processes that insure patients are in the appropriate level of care with supporting documentation for regulatory compliance and accurate coding.

Primary Responsibilities:

  • Conduct medical necessity reviews of cases referred by case management to ensure medical necessity and regulatory requirements are met for level of care
  • Meet with case management, social work, and other healthcare team members to discuss selected cases and make recommendations regarding patient status
  • Interacting with medical staff and medical directors of third-party payers to discuss the needs of patients and alternative levels of care
  • Act as a consultant for the medical staff regarding their decisions for the appropriate level of care of hospitalized patients and supporting documentation
  • Participate in the claims denial process, including appeals
  • Review of utilization data to ensure hospital objectives for quality patient care
  • Act as a resource for the medical staff regarding federal, state, and payer regulatory, quality, and contract requirements
  • Serve as a physician member of the Utilization Review Committee, which may require non-clinical medical staff privileges application
  • Provide education on utilization management topics (e.g. documentation) to the medical and UM staffs Physician Advisor Will Not:
    • Practice medicine during the hours scheduled, which includes:
      • Decision-making in a patient's plan of care or discharge
      • Write orders or prescriptions
      • Provide on-call coverage
      • Set hospital clinical or administrative policies
      • Supervise house staff or hospital employees
      • Participate in any type of peer review (e.g. Quality, M&M)
        Required Qualifications:
        • MD or DO
        • Current, 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 EMRsPreferred Qualifications:
          • Board certified / eligible
          • 3+ years of experience in a hospital-based practice setting As health care continues to change and evolve, so do your opportunities to join a superb team who are working every day to make health care work better.
            Executive Health Resources is part of Optum and the growing family of UnitedHealth Group companies. We help smooth out the interplay between each hospital client and the various payers. How? We serve as an expert partner on issues that confront hospitals every day involving medical necessity, reimbursement, coding and documentation. And while that's a mouthful, it makes us proud to say that we rise to a level of professionalism and quality that can totally invigorate your career.
            Join us today and you'll soon be doing your life's best work.(sm)

            Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
            UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Physician Advisor, Physician Utilization Review, Managed Care, Medical Director, Bowling Green, KY, Kentucky Keyphrases: family medicine jobs, family practice jobs, family practitioner jobs, family medicine specialist jobs

Keywords: Optum, Bowling Green , Onsite Physician Advisor Bowling Green KY (Physician #), Healthcare , Bowling Green, Kentucky

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Healthcare Jobs

68K Medical Laboratory Specialist
Description: The ASVAB isn't the only test that matters in the military. A Soldier's tissue, blood, and body fluids also need to be tested to detect and identify diseases. As a Medical Laboratory Specialist in the (more...)
Company: Army National Guard
Location: Smyrna
Posted on: 08/24/2019

Gastroenterology position in KY
Description: Gastroenterology opening in Bowling Green, Kentucky. This and other physician jobs brought to you by Gastroenterology opening in Kentucky Located in Bowling Green, KY - just 60 (more...)
Company: Archway Physician Recruitment
Location: Bowling Green
Posted on: 08/24/2019

Cardiac Med Surg Nurse - Sign on bonus available
Description: Description br SHIFT: Nights rotating weekends br br SCHEDULE: Full-time br br Hendersonville Medical Center br Above all else, we are committed to the care and improvement of human life. (more...)
Company: TriStar Hendersonville Medical Center
Location: Hendersonville
Posted on: 08/24/2019

Wound Care Physician
Description: Wound Care Physician br If you are a Wound Care Physician with experience, please read on br Top Reasons to Work with Us br 1. Been in operations for over 150 years 2. Advance your career 3. Continuous (more...)
Company: CyberCoders
Location: Owensboro
Posted on: 08/24/2019

Seeking Homeworkers to work with Healthcare Origanization!
Description: Need income Want freedom Missing out on your children's life If this is you, we are looking
Company: Careerathometoday
Location: Owensboro
Posted on: 08/24/2019

Cardiothoracic Surgery Physician Surgeon - Physicians Only Apply - Perm
Description: Medical Doctors Only Apply. A Cardiothoracic Surgery Physician Surgeon practice is seeking a qualified physician for Owensboro, KY. This and other physician jobs brought
Company: Beck-Field & Associates, Inc.
Location: Owensboro
Posted on: 08/24/2019

Endocrinology position in KY
Description: Endocrinology opening in Bowling Green, Kentucky. This and other physician jobs brought to you by Kentucky Endocrinology opening Full time, permanent opening 1 hour to Nashville TN Service (more...)
Company: Archway Physician Recruitment
Location: Bowling Green
Posted on: 08/24/2019

RN Cath Lab / CVICU / CVOR Travel Nurse
Description: Travel CVOR, CVICU Cath Lab Nurses Needed--Wyoming Cardiac Services Travel RN AssignmentsCardiovascular Intensive Care, Cardiac Cath LabCardio-Vascular SurgeryManagement of HCEN spent 25 years with (more...)
Company: HealthCare Travelers (Nursing)
Location: Bowling Green
Posted on: 08/24/2019

Cardiothoracic Surgery position in KY
Description: Surgery-Thoracic opening in Bowling Green, Kentucky. This and other physician jobs brought to you by Cardiothoracic Surgeon opening near Nashville, TN 1 hour to Nashville -Full time -Permanent (more...)
Company: Archway Physician Recruitment
Location: Bowling Green
Posted on: 08/24/2019

House Supervisor - Registered Nurse (RN)
Description: Description SHIFT: Nights rotating weekends br br SCHEDULE: Full-time br br Shift: Full-Time Nights br About our Facility: TriStar StoneCrest proudly serves Rutherford County Tennessee and (more...)
Company: TriStar StoneCrest Medical Center
Location: Smyrna
Posted on: 08/24/2019

Log In or Create An Account

Get the latest Kentucky jobs by following @recnetKY on Twitter!

Bowling Green RSS job feeds