Presence is exceptional care that delivers exceptional outcomes. We would like to invite you to share that gift as our new Physician Advisor at SSM Health. We are seeking a well-renowned Physician Advisor who has the proven ability to engage with their medical staff and hospital leadership and who share our dedication to exceptional care and outcomes.
In addition to being a strong leader and providing support and leadership to the Vice President of Medical Affairs across our St. Joseph's Medical Center in St. Charles, MO and St. Joseph's Medical Center in Lake St. Louis, MO the Physician Advisor will:
The Physician Advisor directly affects hospital reimbursement, CMI, and other utilization metrics through supporting case management, close relationships with medical staff, communication and knowledge of payer practices, and responsibility for hospital utilization metrics.
The ideal candidate will possess strong leadership skills that will play a key role in impacting the rate of observation versus inpatient care.
Review referred medical records and addresses the clinical theory of diagnosis for admission status, continued stay and in coordination of written appeal letters to payors.
Work with the denials/appeals team in concurrent chart review to assess denials and appropriate levels of care.
Daily concurrent chart review on an “as needed” basis by the Case Managers to review current treatment plans, identify unnecessary delays in care, and assist the case managers in facilitating care with the health center and functioning as a liaison to the attending physicians in order to provide the highest quality of care in the most efficient manner possible.
Participates in CDMP program, and addresses any cases referred by the Clinical Documentation Specialists.
M.D. or D.O.
Hold and maintain an unrestricted medical license in the state of Missouri
Meet the requirements (and become a member) of the Hospital medical staff
Strong computer skills and working knowledge of the EPIC EMR
Must have at least 3 years of clinical experience
Internal Number: R2667
About SSM Health
Through our exceptional health care services, we reveal the healing presence of God.
SSM Health is a Catholic, not-for-profit health system serving the comprehensive health needs of communities across the Midwest through a robust and fully integrated health care delivery system. The organization’s nearly 40,000 employees and 11,000 providers are committed to providing exceptional health care services and revealing God’s healing presence to everyone they serve.
With care delivery sites in Illinois, Missouri, Oklahoma and Wisconsin, SSM Health includes 23 hospitals, more than 290 physician offices and other outpatient and virtual care services, 10 post-acute facilities, comprehensive home care and hospice services, a pharmacy benefit company, a health insurance company and an accountable care organization. It is one of the largest employers in every community it serves.