I nova Fair Oaks is seeking an experienced Physician Advisor to join our team!
The Physician Advisor role is an essential role to the successful operation of the hospital. The role comprises of focus and responsibility of medical necessity(reviews and compliance), denial management, LOS, hospital and peer education and physician empowerment. A PA acts as a liaison between the hospital administration, clinical staff and support staff to ensure that there is consistent compliance and communication. Ultimately accountability for the overall quality of care through appropriate healthcare resource utilization as reflected by meeting the LOS and readmission goals is an essential function of this role. This role will include supporting additional system hospitals as well!
It is the role of the Physician Advisor to:
Develop team partnerships and drive operational goals
perform concurrent and retrospective clinical reviews to determine appropriate admission status Provides clinical review on cases referred by case management staff and/or other health care professionals in accordance with the hospitals objectives for assuring quality patient care and effective, efficient, compliant utilization of health care services
Collaborates with case management department and health care team members to discuss selected cases and makes recommendations for care
Interact with medical staff members and medical directors of third party payers to discuss the needs of patients and alternative levels of care.
Participates in the peer review process; makes suggestions on ways to improve this process.
Evaluation of the hospital utilization management program.
Maintains current knowledge of federal, state, and payer regulatory and contract requirements.
Attends continuing education sessions pertaining to utilization and quality management.
Meets with corporate and hospital case management staff as needed.
Internal Number: 59827BR
About Inova Health System
Inova is a global leader in personalized health, which leverages precision medicine to predict, prevent and treat disease, enabling individuals to live longer, healthier lives. At Inova, we serve more than two million people each year from throughout the Washington, DC, metro area and beyond. Inova's mission is to improve the health of the diverse community it serves through excellence in patient care, education and research. At Inova, more than 16,000 employees demonstrate their commitment every day to providing the community with expert, world-class, compassionate patient care.