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Physician Executive Advisor

Overview:

1

Responsibilities:

Job Purpose:

The Physician Advisor (PA) will be a key member of Piedmont Healthcare Corporate Care Management Leadership and serves as a physician leader for supporting Centralized Utilization Management (UM) responsibilities for all Piedmont Hospitals.

The PA will work closely with the UM Team to ensure patients are in the appropriate status and level of care with supporting documentation for regulatory compliance and accurate coding. Acs as the main liaison between Corporate Care Management and the practicing physicians on issues such as determination of a patient status, adequate documentation in the medical record to support the services provided and payer communication.

The PA is responsible for ensuring CMS internal and external audit and all UM regulatory requirements are adhered to for Corporate Care Management / Utilization Management processes.

Qualifications:

MINIMUM EDUCATION REQUIRED:

Medical Doctor or Doctor of Osteopathy

MINIMUM EXPERIENCE REQUIRED:

• Minimum of 5 years recent experience in clinical practice
• Utilization management experience as a member of the Utilization Management Committee (within the last 3 years)
• Current working knowledge of compliance with healthcare law and CMS rules, regulations, and guidance
• Current working knowledge of discharge planning, utilization management, care management, performance improvement and managed care reimbursement

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:

Licensed physician without restriction. Medical Doctor or Doctor of Osteopathy in the state of Georgia

ADDITIONAL PREFERRED QUALIFICATIONS:

Member of a professional association i.e. American College of Physician Advisors (ACPA) dedicated to the support and advancement of the Physician Advisor in practice.

Business Unit : Company Name: Piedmont Healthcare Corporate