Part Time Onsite Physician Advisor Indiana PA

Unitedhealth Group Inc. Indiana , PA 15701

Posted 3 months ago

Expanding access to affordable, high quality healthcare starts here. This is where some of the most innovative ideas in healthcare are created every day. This is where bold people with big ideas are writing the next chapter in healthcare. You'll have the most opportunities to grow and develop! This is the place to do your life's best work.(sm)

This position is for qualified physicians seeking to enter the new and growing non-clinical practice specialty of Physician Advisor with a career trajectory towards a provider or payor medical director and beyond. This position drives performance across our organization by communicating with hospital physicians and utilization management staff at client hospitals to champion best practices for evidence-based care and its documentation. The Physician Advisor will be responsible for establishing, maintaining, and strengthening the relationship with Optum360 Physician Advisor Solutions client hospitals to appropriately optimize the use of Optum360 Physician Advisor Solutions services.

Training will be provided by Optum. The Physician Advisor will join a team of on-site physician advisors across the country.

Primary Scope of Service:

Although the Physician Advisor (PA) is employed by Optum, the intention is that the PA will become a key member of the client hospital's leadership team charged with meeting the organization's goals and objectives for ensuring the effective, efficient utilization of health care services. To this end, the PA will develop expertise on matters regarding physician practice patterns, over- and under-utilization of resources, medical necessity, documentation best practices, level of care progression, denial management, and compliance with governmental regulations and commercial insurance contracts.

The Physician Advisor will work closely with the medical staff, including house staff, hospital leadership, and all utilization management (UM) personnel to develop and implement methods to optimize the use of hospital services. This includes care management processes that insure patients are in the appropriate level of care with supporting documentation for regulatory compliance and accurate coding.

Primary Responsibilities:

  • Conduct medical necessity reviews of cases referred by case management to ensure medical necessity and regulatory requirements are met for level of care

  • Meet with case management, social work, and other healthcare team members to discuss selected cases and make recommendations regarding patient status

  • Interacting with medical staff and medical directors of third-party payers to discuss the needs of patients and alternative levels of care

  • Act as a consultant for the medical staff regarding their decisions for the appropriate level of care of hospitalized patients and supporting documentation

  • Participate in the claims denial process, including appeals

  • Review of utilization data to ensure hospital objectives for quality patient care

  • Act as a resource for the medical staff regarding federal, state, and payer regulatory, quality, and contract requirements

  • Serve as a physician member of the Utilization Review Committee, which may require non-clinical medical staff privileges application

  • Provide education on utilization management topics (e.g. documentation) to the medical and UM staffs

Physician Advisor Will Not:

  • Practice medicine during the hours scheduled, which includes:

  • Decision-making in a patient's plan of care or discharge

  • Write orders or prescriptions

  • Provide on-call coverage

  • Set hospital clinical or administrative policies

  • Supervise house staff or hospital employees

  • Participate in any type of peer review (e.g. Quality, M&M)

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • MD or DO required

  • Current, unrestricted medical license in state of residence

  • 3 years of experience in a hospital-based practice setting

  • Strong computer skills and working knowledge of EMRs

Preferred Qualifications:

  • Board Certified / Eligible

  • Demonstrated ability to build rapport with medical staff and hospital leadership

As health care continues to change and evolve, so do your opportunities to join a superb team who are working every day to make health care work better.

Optum360 Physician Advisor Solutions is part of the growing family of UnitedHealth Group companies. We help smooth out the interplay between each hospital client and the various payers. How? We serve as an expert partner on issues that confront hospitals every day involving medical necessity, reimbursement, coding and documentation. And while that's a mouthful, it makes us proud to say that we rise to a level of professionalism and quality that can totally invigorate your career.

Join us today and you'll soon be doing your life's best work.(sm)

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Physician Advisor, Physician, Hospitalist, Internal Medicine, ER, Medical Director, Indiana, PA, Pennsylvania, Hospital, Clinician, Doctor, Managed Care


icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Occupational Therapist Assistant (Cota) Indiana PA

Select Medical Corporation

Posted 3 days ago

VIEW JOBS 1/14/2020 12:00:00 AM 2020-04-13T00:00 Overview Are you passionate about your profession and motivated to become the best? NovaCare Rehabilitation has an immediate need for a talented Certified Occupational Therapist Assistant (COTA) to join our team in a PRN capacity. COTA will be responsible for providing coverage at our 3 centers in Indiana, Blairsville, and Seward. The ideal candidate will work mostly with hand therapy patients. Experienced in hand therapy preferred but open to new grads with clinical experience in hands. Best practices and evidence-based programs are utilized for individualized patient care. You will work closely with a (large) group of CHTs, working together in the region for support, education and schedule coverage. Our clinics are fully equipped to provide care to patients ranging from post-surgical, non-operative to work conditioning. You will have the opportunity to work closely with excellent hand surgeons. If you are looking for a stable company with an ACTIVE, GROWING and THRIVING national Hand Therapy program, let's talk! Hours Needed: PRN (As Needed) Mon - Fri Compensation. Salary based on experience. Benefits. We do not offer benefits for PRN or Part Time employees. Applying. To apply, create an on-line profile and upload your resume to complete our HR application. NovaCare Rehabilitation is a part of Select Medical Corporation's Outpatient Division, a nationally prominent, locally driven provider of outpatient physical rehabilitation with approximately 1700 locations in 37 states and the District of Columbia. Throughout the country we operate primarily as Select Physical Therapy, NovaCare Rehabilitation, Kessler Rehabilitation Center and KORT. Our highly respected clinical team provides preventative and rehabilitative services that maximize functionality and promote well-being. We develop individualized treatment plans to help achieve each patient's specific goals. Our integrated local market network allows us to effectively partner with physicians, employers, payors and case managers to achieve optimal patient outcomes in a cost-effective manner. We also provide physical therapy and athletic training services to professional sports teams, colleges, universities and high schools. #ACN Responsibilities * Responsible for the evaluation, plan of care, treatment, re-evaluation, discharge, and appropriate communications of high quality hand therapy services to patients and customers. * Develop treatment plans, supervise assistants and aides, contribute to case management, and provide quality patient care. * Maintain positive level of interaction with facilities and clients. Enhance and expand client relations with facilities and their staff. Qualifications * Must be a graduate of an accredited school for Occupational Therapy Assisting. * National registration and state licensure or registration REQUIRED. * Cardio-Pulmonary Resuscitation (CPR) certification. * Valid state driver's license. Additional Data * Our internal education department offers a : National UE symposium, additional certification course available for UE COMT, National journal club, National CHT study group, National hand therapy mentorship program, free local CEU's, webinar training programs, National bulletin boards and blogs, free journal access. * These internal CEU accredited courses are FREE and UNLIMITED * Hand team meetings in each local area and virtual meetings and training available. * Clinical Case Studies & Newsletters * Opportunities to observe in physician clinics and work in contracted positions in physician's clinics * Opportunity for research activities and publications * Opportunity to teach internal courses on a national and local level and contribute to other educational activities * Opportunity to develop and participate in program development for special populations * Opportunity to deliver unique programs to industrial workers: on-site visits, on site therapy, work conditioning, FCE, ergonomic assessments and pre-employment testing. * Our staff includes national speakers and educators, researchers, therapists published in textbooks and peer reviewed journals, active leaders in national associations. * We provide services to professional sports teams, colleges, universities and high schools Select Medical Corporation Indiana PA

Part Time Onsite Physician Advisor Indiana PA

Unitedhealth Group Inc.