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Job ID: 326416

Physician Advisor

Location: Birmingham, AL, United States
Date Posted: Aug 3, 2019

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Job Description

We Are Hiring

Physician Advisor– St. Vincent’s Birmingham - Case Management
  • Full-Time, Day
 
Why Join Ascension:
 
St. Vincent’s Health System, part of Ascension, is made up of St. Vincent’s Birmingham, St. Vincent’s Blount, St. Vincent’s East, St. Vincent’s St. Clair, St. Vincent's One Nineteen Health and Wellness, and the St. Vincent’s Ambulatory Healthcare Network, which includes a wide range of services, from family care to home health. Together, we provide a special brand of personalized, compassionate care that balances high touch with high tech, meeting the needs of people in more than 40 communities.
 
St. Vincent’s Birmingham Hospital:
 
St. Vincent’s Birmingham is located downtown, and it has over 400 beds and provides space for many physician offices.  We are currently in a large renovation project to create more patient rooms and waiting areas. St. Vincent’s provides care for many patients within the downtown area and surrounding communities.   Known for our Birth Suites and Ortho Sports service line, St. Vincent’s has a strong reputation in the Birmingham as the hospital of choice for many services and the hospital is easy to get to from any location.
 
St. Vincent’s Birmingham (Downtown)
  • Largest faith-based, not for profit hospital in Birmingham.
  • Currently renovating hospital rooms and waiting areas.
  • Expansion of our parking decks to accommodate patients and employees.
  • Free parking for our associates.
  • Several satellite parking lots available with free shuttle service to the hospital.
  • Friendly family environment.
  • “Where Babies are Born!”
  • World renowned Andrews Sports Medicine Orthopedic Center.
  • Downtown location appeals to those that love city life, just minutes from great restaurants, entertainment, historical sites and affordable housing.
  • Skilled staff that care about the patients and each other.
 
What you will do:
 
As an Associate with St. Vincent's Health System-AL, you will have the opportunity to provide medical direction in the care management, clinical documentation improvement, coding, quality and/or compliance process.
 
Responsibilities:
  • Reviews medical records of identified patients to assist with the level of care and length of stay determination.
  • Assists and manages the denial management process. Reviews and offers suggestions related to resources and service management.
  • Provides education to physicians and other clinicians on regulatory requirements, appropriate utilization of alternate levels of care, community resources and end of life care.
  • Develops strategy and processes to reduce denials and audits. Assists with appeals.
  • Utilizes hospital data sources to identify & analyze patterns of over or under-utilization of services, quality metrics and makes recommendations towards achievement of those goals.
  • The physician advisor is a physician with a broad base of clinical experiences who acts as a liaison between the hospital administration, clinical staff, and support personnel to ensure compliance with regulatory issues, advise physicians on medical necessity, and help the leadership team reach overall organizational goals related to the efficient utilization of health care services. 
What you will need:
 
Licenses/Certifications/Registration:
  • Required Credential(s):
    • Physician MD/DO credentialed from the Alabama Board of Medical Examiners obtained prior to hire date or job transfer date. 
    • Physician MD/DO obtained prior to hire date or job transfer date. 
Education:
  • Diploma 
    • 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
Preferred Experience:
 
  • Previous Physician Advisor OR managed care OR Population Health OR CDI  (Clinical Documentation) experience preferred.
  • Knowledge CMS Regulations 
  • Experience with insurance on the payor side strongly preferred
 
 
 
As an equal opportunity employer, St. Vincent's and all its ministries comply with all applicable employment laws and regulations.  In order to provide equal employment opportunities to all individuals, employment decisions at St. Vincent's and all its ministries based on merit, qualifications and abilities.
Employment decisions are made without regard to race, color, disability, protected veteran status, sexual orientation, national origin, age or any other characteristic protected by law.                                         
 
Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
St. Vincent's participates in the Electronic Employment Verification Program. Please click the E-verify link below for more information.  
E-Verify (link to E-verify site) 
 
 
 
 
 
 
 
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