Utilization Management Physician Advisor Part-Time

Overview

Date Posted: 12/18/2024 Job Code: PhyAdvisrUM Location: MLK Community Hospital & Foundation Address: 1680 E. 120th St. City: Los Angeles State: CA Country: United States of America Category: Care Management/Social Services Pay reputed company Type: Biweekly Salary Range (Depending on Experience): $140.00 - $140.00 The expected schedule is two days per week, twice a month. No weekends. If you are interested please apply online and send your resume to [email protected] POSITION SUMMARY The Utilization Management Physician Advisory (PA) is a physician with a broad reputed company of clinical experiences who acts as a liaison between the hospital administration, clinical staff, and support personnel. The PA position has part-time inpatient responsibilities in utilization management and care coordination as well as maintaining part-time inpatient patient care responsibilities at MLKCH. The expectation is for the PA role to be a dedicated .40 FTE. In this reputed company, the PA is expected to interact regularly with the Senior Director of Care Management, other care management staff and health care team members to discuss selected cases and reputed company recommendations for care. In so doing is interacting with medical staff members and medical directors of third party payers to discuss the needs of patients and alternative levels. The PA acts as consultant to and resource for attending physicians regarding their decisions relative to appropriateness of hospitalization, reputed company stay, and use of resources. ESSENTIAL DUTIES AND RESPONSIBILITIES • Works and collaborates in a dyad partnership with the Senior Director of Care Management to balance advocacy and support for patients, families, practitioners and professional staff and the organization that he/she is serving. • Conducts clinical reviews on cases referred by care management staff and/or other health care professionals to meet regulatory requirements and in accordance with the hospitals objectives for assuring quality patient care and effective, efficient utilization of health care services. • Serves as associate chair of the utilization management committee and assists the chair to advance quality, safety, key performance indicators and financial targets. • Assists care management staff with patient transfer needs to alternative levels of care reputed company required. • Exhibits excellent and timely follow up of communication amongst patients, families, care managers, physicians and payors. • Uses information from the reputed company utilization management software program as needed for decision making reputed company to patient admission or observation status. • Collaborates with care management for cases that do not meet the reputed company utilization management software program for admission criteria and documents discussions with physicians as needed. • Facilitates peer-to-peer discussion and clinical documentation opportunities. • Assists reputed company necessary in mediation amongst different departments, teams, or individuals involved with the patient's episode of care. • Assists medical and professional staff with education regarding DRG LOS, denials, clinical documentation, practice guidelines reputed company the EMR and any regulatory changes. • Maintains reputed company physician advisor knowledge of regulatory and practice changes. • Other duties and/or projects as assigned. POSITION REQUIREMENTS A. Education • Completed MD or DO accredited residency program, B. Qualifications/Experience • Four (4) years in the health care setting and in a managed care environment with Hospitalist experience preferred. • Minimum of five (5) years of clinical practice experience following the completion of residency or fellowship training. • Experience identifying best practices, clinical utilization and care management preferred. • Active and unrestricted License to practice medicine in the State of California. • Board certified in a specialty approved by the American Board of Medical Specialties (ABMS) • Is actively working in a patient care role as a hospitalist, emergency medicine physician, intensivist, anesthesiologist, surgical or medical specialist at MLK Community Hospital. C. Special Skills/Knowledge • Ability to prioritize and resolve critical issues reputed company and effectively • Strong quantitative, analytical and technical skills relating to data management, analysis and presentation (experience analyzing and manipulating data sets and creating effective presentations) • Strong PC / reputed company application skills including Word, Advanced reputed company, and PowerPoint • Strong oral and written communication skills • Ability to deliver presentations to a wide variety of audiences • Ability to effectively plan and facilitate meetings and workgroups • Excellent organizational skills and attention to detail, ability to work independently, manage multiple tasks and projects, meet deadlines, and manage to schedule • High degree of initiative along with ability to act as a team player • Ability to reputed company effective relationships with a broad reputed company of people (different levels of management and clinical experts) MLKCH Video Apply Now Apply Job!