As an Optum Physician Advisor, you will serve as a liaison between the clinical staff and hospital administration, working closely with case management (length of stay, patient status), medical necessity, Medicare regulations, claim denials and documentation. This is a salaried, Full time onsite role, Monday-Friday. (No week-ends and No on call.)
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.
Physician Advisor Will Not:
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.
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)
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Physician Advisor, Medical Director, Physician Utilization Review,
Physician, Hospital, Clinician, Doctor, Managed Care, Utilization Review, UR, UM, Utilization Management, CDI, Hospitalist, Case Review, Medical Necessity, peer to peer, EMR, EHR, LOS, denials, Hospital Administration, Utilization Review Committee
Clinical Documentation Improvement, Clinical Informatics, Springfield, MA