Physician Advisor

At Houston Methodist, the Physician Advisor position is responsible for teaching, consulting, and advising the case management department, clinical documentation specialists, medical staff, and the hospital on matters regarding medical necessity, compliance rules, and resource utilization. This role serves as a key member and leader of the hospital's utilization review/management committee, conducting clinical reviews and ensuring high levels of healthcare quality.

The Physician Advisor collaborates across interdisciplinary teams to optimize patient outcomes, manage length of stay, and support clinical documentation improvement.

Practice Info

• Houston Methodist Clear Lake Hospital
• Broad spectrum of adult, pediatric, medical and surgical care
• Accredited chest pain center and acute stroke-ready designated through DNV
• Advanced inpatient and outpatient services including state-of-the-art imaging, childbirth center with a level II neonatal intensive care unit, minimally invasive surgery, cancer center, neurology and spine care, heart and vascular care, bariatric and digestive care, emergency care, primary care, rehabilitation services, and comprehensive orthopedics and sports medicine

Responsibilities

• Interact with medical staff members to discuss needs of patients and alternative levels of care
• Provide consultation to case management staff regarding complex clinical issues and advises on next steps
• Provide feedback to attending and consulting physicians regarding level of care, length of stay, and quality issues
• Chair the utilization review/management committee, actively participates in defining operational strategic objectives for the Utilization Management Program and serve as the liaison to other medical staff committees
• Round on the patient care units, and throughout the hospital, to identify opportunities to impact resource utilization and manage length of stay
• Provide support and assists Clinical Documentation Specialists and Coders on an ongoing basis by addressing specific documentation issues
• Review medical records identified by case managers, or as requested by other members of the healthcare team, in order to assist with the identification and management of denials
• Provide ongoing education to physicians and other providers on regulatory requirements, appropriate utilization of alternate levels of care, and clinical documentation

Shift & Schedule

• FLSA STATUS Exempt
• Work Shift : 1 - Day (United States of America)

Requirements

• Graduate of accredited medical school
• Five years experience in clinical practice
• MD
  - Physician
  - State Licensure
  - Texas Department of Licensing and Regulation
• Unrestricted medical license in the State of Texas
• Active practitioner
• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions
• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
• Ability to foster positive medical staff relations and work effectively with all healthcare disciplines
• Demonstrates understanding and knowledge of utilization management, clinical documentation, and state and federal healthcare regulations