oracle
Physician Advisor PRN
Centra Health, Inc
Lynchburg, USA
Mid · 3–5 years experience
Onsite
Discovered 1 weeks ago
Full Job Posting
Qualifications
- Education & Certification
- MD or DO with active board certification in a clinical specialty.
- Current license to practice medicine in Virginia.
- Minimum 3–5 years of clinical practice experience.
Responsibilities
- Leadership and Collaboration
- Support the Physician Advisor Director with building the comprehensive program with scheduling and coverage support, leadership development, and programmatic budgeting
- Act as a trusted clinical advisor, fostering alignment between physicians and operational priorities.
- Partner with Physician Advisor Director leading clinical teams in performance improvement initiatives related to LOS, documentation, throughput, and cost of care.
- Support alignment with system-wide strategies in:
- Inpatient Clinical Optimization
- Clinical Documentation Improvement
- Regulatory Readiness
- Cost-of-Care Management
- Utilization Management
- Review cases to assess medical necessity, appropriate level of care, and length of stay, especially outliers.
- Participate in multidisciplinary rounds to identify and mitigate care progression delays.
- Facilitate peer-to-peer conversations about medical necessity determinations and payer disputes.
- Support throughput efforts by identifying and resolving discharge barriers.
- Provide input on observation status determinations and ensure appropriate clinical documentation.
- Clinical Documentation Integrity (CDI)
- Engage physicians to improve documentation accuracy, specificity, and timeliness.
- Collaborate with CDI and coding teams to address quality metrics influenced by documentation (e.g., PSI-90, SOI/ROM).
- Review query response trends and support escalation or education as needed.
- Provide education to clinicians on CDI principles, DRG optimization, and coding best practices.
- Regulatory & Compliance
- Ensure compliance with CMS Utilization Management requirements, including Conditions of Participation and relevant policies.
- Support the development and implementation of UM plans, committee structures, and documentation workflows that align with federal and state regulations.
- Monitor performance and recommend process improvements for compliance and efficiency.
- Education & Engagement
- Translate data into actionable insights for clinical teams, connecting administrative and clinical priorities.
- Champion initiatives promote accountability, clinical consistency, and optimal use of hospital resources.
About Centra Health, Inc
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