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Physician Advisor PRN

Centra Health, Inc
Lynchburg, USA
Mid · 3–5 years experience
Onsite
Discovered 6 days 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.

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