Physician Advisor

at  Ascension

REQUIREMENTS

Licensure / Certification / Registration:

• Physician MD/DO credentialed from the Texas Medical Board obtained prior to hire date or job transfer date required.

Education:

• Doctor of Medicine (MD) or Doctor of Osteopathy (DO) or Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) or Doctor of Optometry (OD) or Doctor of Podiatric Medicine (DPM) required.

Provide medical direction in the care management, clinical documentation improvement, coding, quality and/or compliance process.

• Review medical records of identified patients to assist with the level of care and length of stay determination.
• Assist and manage the denial management process. Review and offer suggestions related to resources and service management.
• Provide education to physicians and other clinicians on regulatory requirements, appropriate utilization of alternate levels of care, community resources and end of life care.
• Develop strategy and process to reduce denials and audits. Assist with appeals.
• Utilize hospital data sources to identify & analyze patterns of over or under-utilization of services, quality metrics and make recommendations towards achievement of those goals.