<p>Enterprise Physician Advisor</p> <p>The Physician Advisor works in collaboration with institute, market, and enterprise leaders in aligning interests between physicians, administration, Allied Health Professionals, and third-party payers. Promote standardization of clinical practices and documentation, prevent and reduce denials, improve relationships with payers and outcomes, develops and delivers education, and functions as a clinical resource, and consultant to Finance, Medical Staff and Utilization Management. Reports to the Assistant Medical Director Physician Advisory Program RCM.</p> <p>Responsibilities:</p> <ul> <li>Participate in documentation and medical necessity improvement initiatives. </li><li>Actively engage and recommend process improvement initiatives (i.e. level of care guidelines, length of stay, readmissions, medical documentation) while driving accountability to achieve the best outcomes. </li><li>Participate in status management, denials management and prevention, observation status management, surgical reviews, 2nd level medical necessity, and Peer-to-Peer reviews. </li><li>Develop and deliver education to the medical staff and clinical and administrative leaders. </li><li>Support utilization management, clinical documentation integrity and denials management teams. </li><li>Monitor providers' compliance to CMS and third-party payor regulations and intervene when needed. </li><li>Assist in payor contracting negotiations as requested. </li><li>Attend Hospital Executive Management meetings accordingly. </li><li>Other duties as assigned. </li></ul> <p>Education:</p> <ul> <li>MD degree. </li><li>Current license to practice in the State of Ohio in good standing. </li><li>Education in business and/or healthcare administration is preferred. </li></ul> <p>Languages:</p> <ul> <li>Oral and written communication in English </li></ul> <p>Certifications:</p> <ul> <li>License to practice medicine in the state(s) in which the role is practicing and hospital credentials/privileges at practicing hospital(s). </li><li>Credentialed in hospitals across the system. </li></ul> <p>Complexity of Work:</p> <ul> <li>Incumbent must have strong delegation, planning organization, communication, analytical and strong interpersonal skills. </li></ul> <p>Work Experience:</p> <ul> <li>Minimum 7 years of professional and functionally relevant experience required. </li></ul> <p>Physical Requirements:</p> <ul> <li>Ability to perform work in a stationary position for extended periods. </li><li>Ability to operate a computer and other office equipment. </li><li>Ability to communicate effectively and exchange accurate information. </li><li>Ability to travel throughout the health system both domestically and internationally. </li></ul> <p>Personal Protective Equipment:</p> <ul> <li>Follows standard precautions using personal protective equipment as required for procedures. </li></ul> <p>Learn more about Cleveland Clinic</p> <p>About Cleveland Clinic</p> <p>Living in Cleveland</p> <p>Take a Tour</p> <p>About Us</p> <p>Cleveland Clinic's vision is to become the best place for care and the best place to work in healthcare. We are committed to providing a safe, stable, and financially fulfilling work environment. Cleveland Clinic is ambitiously investing in growth. Being a physician-led organization means doing what is best for the patients, every day.</p> <p>Cleveland Clinic is one of the world's largest and busiest health centers. Patients come to Cleveland Clinic from all over the world. We offer advanced treatment for all illnesses and disorders of the body.</p> <p>Cleveland Clinic is a nonprofit, multispecialty academic medical center that's recognized in the U.S. and throughout the world for its expertise and care. Cleveland Clinic integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S. News & World Report consistently names Cleveland Clinic as one of the nation's best hospitals in its annual America's Best Hospitals survey. Among Cleveland Clinic's 80,642 employees worldwide are more than 5,743 salaried physicians and researchers, and 20,166 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,690-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, more than 270 outpatient facilities, including locations in northeast Ohio; southeast Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2023, there were 13.7 million total outpatient visits, 323,000 hospital admissions and observations, and 301,000 surgical cases throughout Cleveland Clinic's health system. Patients came for treatment from every state and 185 countries.</p> <p>Cleveland Clinic has been named one of America's Best Employers for Diversity in 2023.</p> <p>Our Culture</p> <p>Cleveland Clinic is pleased to be an equal employment opportunity employer. Smoke/drug free environment.</p> <p>Any application submitted without a CV will delay the review process</p> <p>Please be advised that all information entered in your application will only be shared with Cleveland Clinic and will not be distributed to third parties.</p> <p>About the Community</p> <p>Cleveland is part of Northeast Ohio which is composed of six metropolitan areas. Each of them provides affordable real estate, excellent schools, safe communities as well as an abundance of outdoor activities. Find out here how great it is to live in Cleveland!</p> <p>Information for Candidates</p> <p>Candidates will only be asked to provide personal documents once an offer of employment has been made and accepted. Recruitment scams are becoming increasingly common online, with false advertisements and requests for payment or personal details claiming to come from reputable organizations. Please be assured that our physician recruiters will never ask for payment from candidates at any stage of the recruitment or offer process.</p> <p>Disclaimer</p> <p>Cleveland Clinic Health System administers an influenza prevention program. You will be required to comply with the program, which will include obtaining an influenza vaccination or an exemption.</p>