Board-certified Physician with inpatient experience
Familiarity with CMS and commercial insurance regulations
Experience on hospital committees
Team-building mindset
Collaborative approach to decision making
Responsibilities
Lead clinical resource utilization program
Review cases for appropriate levels of care
Serve as a resource for physicians on medical necessity
Foster communication among care team members
Establish and maintain peer-to-peer protocol
Work onsite
Benefits
Competitive base salary plus nonproduction incentives
Paid malpractice insurance
403B retirement plan with matching contributions
Opportunities for educational advancement
Supportive community and affiliations with 14 local hospitals
Full Job Description
Employment Type: Full timeShift:
Description:
MercyOne is seeking a dynamic, board-certified Physician with Inpatient experience for a newly opened but established role as a Physician Advisor. The ideal candidate will have served on Hospital committees or strong working knowledge of CMS and commercial insurance regulations. The Physician Advisor must possess a team-building mindset and a collaborative approach to decision making. MercyOne offers a competitive base salary plus nonproduction incentives, paid malpractice, and a 403B match.
Essential Job Details: • Lead physician-driven clinical resource utilization program, and work with MercyOne Leadership team to design interventions when necessary • Review cases to determine appropriate level of care based on medical necessity, and apply regulatory, health plan, and clinical guidelines in the review of denials • Serve as a resource for physicians regarding medical necessity, level of care, and clinical documentation • Foster effective communication between members of the care team • Establish and maintain peer-to-peer protocol • Establish peer-to-peer protocol • This is an onsite position
