Physician Advisor

The Physician Advisor (PA) team for relative duties report to the System PA Lead and support the PA program for UH. The PA help to create and update formal training and education programs for UH providers helping to hardwire and sustain adherence to documentation requirements reflecting appropriate level of care, care setting, and clinical documentation that accurately reflects patient severity of illness, risk of mortality and appropriate reimbursement for hospital services. The PA provides support to the care team ensuring medical Staff, leadership, resource management and all patient care support teams to conduct clinical reviews on cases in accordance with hospitals objectives and policies for assuring quality patient care and effective, efficient utilization of health care services, and to meet regulatory requirements.

The PA meets with UM and the health care team member to discuss selected cases and make recommendations for level of care. The PA interacts with medical staff, leaders, third party payers to discuss needs of patients and alternative level of care. The PA acts as a consultant resource to attending physicians regarding their decisions relative to appropriateness of hospitalization, continued stay, use of resources and comprehensive and accurate clinical documentation. He or she acts as a resource to medical staff regarding federal and state utilization and quality regulations as well as compliant documentation and coding to support technical billing and reimbursement.

Through collaboration with all members of the health care and business teams, patient and family, to coordinate timely, effective and efficient delivery of required patient information and services to result in:

* Positive patient/family, provider and team experience and satisfaction

* Timely and accurate capture of information in compliance with governmental and 3rd party agencies that supports appropriate reimbursement and collection of expected payment for services provided.

* Improved efficiency and standardization of services, service and performance metrics

* Improved service delivery in every care setting; inpatient throughput from admission to discharge

* Model strong relationships with provider and clinical staff along with associated leadership and staff alike to support open collaboration and breakdown barriers to establishing joint workflow and policies with other departments/areas to influence decreased denials and appropriate reimbursement.