Executive Director, Physician Advisor

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How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well–being of every person we serve. We are proud to have become a shining example of what’s possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry and in people’s lives.

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The Physician Advisor reports to and is accountable to the Vice President Medical Affairs (VPMA) to impact quality, utilization, patient satisfaction and efficiency metrics through performance improvement and education initiatives that will enable the facility to achieve its stated goals. Working in collaboration with the VPMA(s) in the Well Star Health System (WHS), the Physician Advisor (PA) will be involved in utilization management, quality improvement, and ongoing education to support efficient, high‑quality patient care.

• Assist with level of care and length of stay management. This will include assessment of Inpatient vs. Outpatient Observation Status; compliance with 2‑Mn Rule, assistance with throughput initiatives and care transition issues.
• Lead Readmission reduction initiatives at the facility with the Chairperson of the Readmission PIC and in collaboration with the VPMA.
• Assist with denial management process on a concurrent basis if possible.
• Work closely with the Care Coordination Leadership to expedite case management issues and manage work queues.
• Review and make suggestions regarding resource and service management.
• Assist staff with clinical review of patients.
• Review clinical records for appropriate and accurate clinical documentation to ensure that medical necessity and level of care for services will be substantiated.
• Will work with the Clinical Documentation Excellence Specialists (i.e., CDS/CDI) to assist with physician queries for documentation or clinical criterion clarification.
• Will work with Hospital‑based physician Medical Director(s) to address throughput, Length of Stay, excess days and other issues and barriers related to the continuum of care to improve efficiency.
• May be involved in development and planning of care for specialized patient populations or those requiring Complex Disease & Care management.
• Plan and develop any programs necessary to help facilitate the management of patient populations through the continuum of care.
• Determine if professionally recognized standards of quality care are met by working with the Quality Department and available resources with appropriate referral to the Peer Review process if necessary.
• Assist in review of any reports from regulatory agencies, i.e., RAC audits, QIO reports, etc., to help determine trends, develop replies to inquiries and action plans for improvement.
• As part of his/her duties, the Physician Advisor will participate in a limited on‑call schedule with other colleagues as determined by the team. The expectation is that the PA will be available by phone and electronically to conduct phone consultation and chart review to assist the Care Coordination teams on site for all of the Well Star facilities.
• Supports planned, sequenced ongoing education about payer and utilization matters, best clinical practice data and research, health‑care trends, collaborative initiatives and skills, post‑acute continuum capabilities, changes in Hospital policies and operations, and other salient subjects to physicians (on staff and private practice), physician assistants and nurse practitioners, Medical students and others.
• Functions as a consultant to the Care Management Department to ensure adequate structure within the Hospital to allow efficient and effective delivery of service.
• Responds in a timely manner to requests to intervene with payers, denials and appeals processes, observation level of care, decisions regarding admission and the transition of patients through levels of care,…