Description

Job Summary and Responsibilities

As our Physician Advisor, you will promote evidence-based medical care and appropriate hospital resource utilization, facilitating communication across medical, nursing, care coordination, and administrative departments.

Every day you will advocate for efficient patient care, remove barriers, and collaborate with attending physicians, bolstering the Department of Care Coordination's utilization and compliance efforts.

T o be successful, you need exceptional clinical acumen, strong communication, and a deep understanding of hospital operations/regulations. Your ability to influence, drive efficiency, and advocate will be paramount for optimizing care and resource allocation.

• Mitigate denials for payment from insurance payers by providing valid and effective secondary medical necessity reviews. Review and report performance measures and make recommendations to Departments and the Medical Executive Committee regarding opportunities for improvement of patient care, resource utilization, billing compliance and reduction of claims denials.
• Provide compliance element for Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (COP) by performing secondary medical necessity reviews.
• Provide a more cost-effective delivery of secondary medical necessity reviews than what is currently provided by outside contracted services (Executive Health Resources (EHR).
• Align and collaborate with the facility leadership.
• Understand and appreciate unique elements of facility history and culture in order to effectively execute/implement job duties and functions.

Job Requirements

Required

• Five (5) years clinical practice experience
• Doctor of Medicine (MD) or Doctor Osteopathic Medicine (DO) in the state of Arizona.

Preferred

• One (1) year of experience in Utilization Management

Where You'll Work

Hello Humankindness: Join a Legacy of Healing at Saint Joseph's Hospital and Medical Center (SJHMC)

Ready to make a real difference? Join SJHMC in Phoenix AZ., a 571-bed nonprofit founded by the Sisters of Mercy over 125 years ago. We're more than a hospital; we're a global destination for life-changing care, embracing patients with humankindness.

Here, your calling will flourish. We're not just a workplace; we're a community dedicated to a mission of service.

Leaders in Specialized Care:

• Barrow Neurological Institute (BNI): A world-renowned center for groundbreaking neurological research and innovative treatments.
• Norton Thoracic Institute (NTI): A national leader in advanced thoracic care with pioneering surgical techniques.
• Level I Trauma Center: One of Arizona's busiest ERs, providing immediate, comprehensive care for critically injured patients 24/7.

Why SJHMC?

• Culture of Excellence & Well-being: We care for our people, fostering professional and personal growth.
• Community & Collaboration: Be part of a network committed to global health and well-being.
• Join a Legacy, Shape a Future: Over 20% of our patients travel internationally for our specialized care.

This is an invitation to join a family of dedicated professionals at the forefront of medical innovation, united by the power of humankindness.