Job Description - Medical Director Physician Advisor UM - Remote (25033023)
Job Description
Medical Director Physician Advisor UM - Remote (
Description
All the benefits and perks you need for you and your family :
Paid Days Off from Day One
Student Loan Repayment Program
Career Development
Whole Person Wellbeing Resources
Mental Health Resources and Support
Our promise to you :
Joining AdventHealth is about being part of something bigger. Its about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule : Full Time
Shift : Days
Location: 3100 East Fletcher Avenue Tampa, Florida 33613
The community youll be caring for: AdventHealth Division
AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital located in the uptown district of Tampa, Florida, specializes in advanced cardiovascular medicine, neuroscience and neurology, digestive health, orthopedics, womens services, pediatrics, oncology, endocrinology, bariatrics, wound healing, sleep medicine and general surgery including minimally invasive and robot-assisted procedures. GME programs on the hospital campus currently include general surgery, obstetrics and gynecology, internal medicine and transitional year.
AdventHealth Tampa is home to the renowned AdventHealth Pepin Heart Institute, a recognized leader in cardiovascular disease prevention, diagnosis, treatment and leading-edge research caring for Tampa Bays hearts for over 35 years.
The Kiran C. Patel Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, advanced surgery and more contributing valuable knowledge that leads to tomorrows cures for conditions such as heart failure, cancer and other diseases.
The role youll contribute :
The Physician Advisor provides primary support for Utilization Management (UM) and secondary support for Care Management (CM) departments and serves as a liaison between UM and CM teams and medical staff, as well as, the medical liaison for payor escalations. The Physician Advisor is responsible for educating, informing and advising members of the Utilization Management, Care Management, Managed Care and Revenue Cycle departments and applicable medical staff, as well as collaborating with other disciplines to assist in the improvement of clinical documentation, patient safety, and quality outcomes.
Through primary support of Utilization Management, the Physician Advisor is responsible for providing clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient care/observation stays and referral services. The Physician Advisor is an important contact for clinicians, external providers, contracted health insurance payors, and regulatory agencies. This individual also serves as the subject matter expert, providing clinical expertise and business direction in support of medical management programs, promoting the delivery of high quality, patient focused and cost-effective medical care.
The value youll bring to the team :
Provides clinical support/validation for both Utilization Management and Care Management teams
Provides education and serves as a resource to Medical Staff colleagues regarding best practices, Utilization Management and Care Management structures, and functions and use of clinical guidelines
Develops and facilitates productive internal/external relationships with all physicians and constituents of Utilization Management and Care Management
Provides suggested approaches to clarifying clinical questions when Utilization Management and Care Management staff interact with physicians, nurses, or other health professionals
Maintains a positive and supportive relationship between the inpatient facilities, payors and physicians (hospitalist groups and primary care providers), and acts as the interdepartmental liaison for ACO activities and program development.
Qualifications
The expertise and experiences youll need to succeed :
Graduate of accredited Medical School
Bachelor of Science
Minimum of 5 years of experience in hospital medicine in acute care setting
Current and valid license as a physician
Board certified and eligible for membership on the Hospital medical staff
Operating Unit : AdventHealth West Fl Division
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