Onsite Physician Advisors - Norfolk and Virginia Beach, VA
Company: UnitedHealth Group
Location: Virginia Beach
Posted on: January 22, 2023
Job Description:
Combine two of the fastest-growing fields on the planet with a
culture of performance, collaboration and opportunity and this is
what you get. Leading edge technology in an industry that's
improving the lives of millions. Here, innovation isn't about
another gadget, it's about making health care data available
wherever and whenever people need it, safely and reliably. There's
no room for error. Join us and start doing -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 Optum client
hospitals to appropriately optimize the use of Optum
services.Training will be provided by Optum. The Physician Advisor
will join a team of on-site physician advisors across the
country.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 ensure
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 -
- Interact 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 staffsPhysician 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 DOCurrent, unrestricted medical license in
state of residenceDemonstrated ability to build rapport with
medical staff and hospital leadershipSolid computer skills and
working knowledge of EMRsYou will be asked to perform this role in
an office setting, however, may be required to work from home
temporarily due to space limitations**All Physician Advisors have a
shared Minimum Holiday coverage requirement which is covered
remotely.Preferred Qualifications:3+ years of experience in a
hospital-based practice settingBoard Certified / Eligible -Careers
with Optum. -Here's the idea. We built an entire organization
around one giant objective; make health care work better for
everyone. So when it comes to how we use the world's large
accumulation of health-related information, or guide health and
lifestyle choices or manage pharmacy benefits for millions, our
first goal is to leap beyond the status quo and uncover new ways to
serve. Optum, part of the UnitedHealth Group family of businesses,
brings together some of the greatest minds and most advanced ideas
on where health care has to go in order to reach its fullest
potential. For you, that means working on high performance teams
against sophisticated challenges that matter. Optum, incredible
ideas in one incredible company and a singular opportunity to do
-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. - -
Keywords: UnitedHealth Group, Virginia Beach , Onsite Physician Advisors - Norfolk and Virginia Beach, VA, Healthcare , Virginia Beach, Virginia
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