Physician Advisor - MedStar Multisite

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Med Star Health is seeking a Physician Advisor to join our team at Med Star Washington Hospital Center in Washington DC. The Physician Advisor is an essential part of the team, using medical expertise to optimize resource use, reduce length of stay, and prevent clinical denials. Their work ensures patients receive appropriate, timely care. This will be a hybrid role.

• Review patient status, medical necessity, and level of care
• Lead clinical denial interventions, denial root cause determinations and upstream process improvement initiatives.
• Engage in concurrent and retrospective denials management and peer to peer discussions with payers
• Drive length of stay improvements in close collaboration with case management and hospital stakeholders
• Provide education to physicians and other clinicians related to regulatory requirements, appropriate utilization of hospital services, community resources, and alternative level of care
• Participate in Interdisciplinary Rounds (IDR) with the Healthcare Team as indicated.
• Ensure regulatory compliance of Utilization Management and Discharge planning processes

• A competitive salary
• Medical, dental, and vision insurance
• Paid malpractice insurance
• Paid Time Off
• Retirement plan

• Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) - Board Certification required (Internal Medicine or Emergency Medicine preferred)
• Preferred:
  Additional certification in healthcare administration, business, or physician advisory

• Minimum 5 years of direct clinical practice required, hospital based experience preferred
• Previous experience as physician advisor preferred
• Strong knowledge of case management, utilization review, regulatory standards, denials management, observation medicine, and length of stay
• Familiarity with MCG and Inter Qual clinical criteria

• Current medical license in the practicing state
• Board Certified
• Preferred: ACPA-C or ABQUARP certification in Physician Advisory (or willingness to obtain within 1 year of hire)

USD $ - USD $ /Yr.

Not Applicable

Full-time

Health Care Provider

Hospitals and Health Care