Permanent Internal Medicine Director Physician in Chicago, Illinois
Company: National Health Partners, Inc
Location: Chicago
Posted on: May 16, 2022
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Job Description:
Internal Medicine Director physician employment in Illinois :
Hospital in Chicago is seeking an experienced Board-Certified
Internal Medicine physician to join our hospital as a Physician
Advisor. WHAT WE NEED: Ideal candidate must have 7 years of
experience as an internal medicine/sub-specialty physician. The
Physician Advisor (PA) is expected to advise, educate and assist
the local facility/facilities through teaching, consulting, and
advising the Case Management (CM) Department, Clinical
Documentation Improvement (CDI) Department and the medical staff on
matters regarding physician practice patterns, documentation, over-
and under-utilization of resources, medical necessity, compliance
rules and regulations, collaboration and relationships with payers.
The PA will work collaboratively with the local leadership to
address identified issues with practice patterns of specific
providers. WHAT YOU CAN EXPECT: Promote compliance with CMS, State
and Payer policy regarding inpatient admissions and observation
status, as well as the appropriateness of continued hospital stay.
Work with Director of Clinical Effectiveness and Care Management to
facilitate communication between payers and providers regarding
benefit coverage issues, denials, utilization review and quality
assurance processes. In addition, position requires professional
engagement with the Vice President of Medical Affairs, Corporate
Lead PA and System Medical Director Ensure Quality improvement
activities comply with all relevant requirements by State /Federal/
Accreditation Body. Conduct verbal and written review (including
peer-to-peer) and appeal of denied or downgraded coverage
determinations made by payers at local facility. Provide feedback
to treating physicians (attending and consultants) on appropriate
level of care, length of stay, and quality issues. Also seek
additional clinical information from the treating physicians
(including appropriate documentation of the plan of care to resolve
utilization issues or modification to the treatment plan) to ensure
adherence to regulatory and compliance requirements. Reviews
medical records of patients referred by the care management team
and assist with clinical review for level of care determination,
length of stay management, denial management process and determine
if MCG criteria or other professionally recognized standards of
quality care are met. Must portray excellent interpersonal and
communication skills, with the ability to build consensus;
noticeable skills in engaging physicians and finding synergies. The
ability to relate well to a wide variety of individuals.
Comfortable working in groups, forming team Board Certified or
Board Eligible Medical Doctor with or w/o US residency with current
US work visa.
Keywords: National Health Partners, Inc, Chicago , Permanent Internal Medicine Director Physician in Chicago, Illinois, Executive , Chicago, Illinois
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