<p>The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level of care, patient billing status, and potential barriers to patient discharge. Serves as the senior physician leader for utilization management, care progression, and documentation alignment across the health system. Works in close partnership with care management, CDI and medical staff leadership to build an oversee the physician advisor program and drive throughput, length of stay reduction, and documentation integrity.</p> <ul> <li>Active member of a Medical Staff with > 5 years' experience. </li><li>Broad range of medical/clinical knowledge. </li><li>Expertise in utilization management, state/federal regulations, private payer contracts. </li><li>Dedication to quality, safety, efficiency, satisfaction, and cost reduction. </li><li>A good communicator with strong interpersonal, leadership, communication, and teaching skills. </li><li>Ability to collaborate with front-line staff and executive leadership. </li></ul> <p>Program Development and Leadership</p> <ul> <li>Build and lead the system-wide Physician Advisor program </li><li>Serve as liaison between Care Management, CDI, Revenue Cycle, and medical staff. </li><li>Define structure, workflow, and metrics for program success. </li></ul> <p>Utilization Management and Clinical Alignment</p> <ul> <li>Review medical necessity, admission status, and 2-midnight compliance. </li><li>Perform concurrent review of complex and extended LOS cases. </li><li>Lead payer discussions, denials, and appeals. </li><li>Identify opportunities to reduce avoidable delays and optimize care transitions. </li></ul> <p>Educations and Physician Engagement</p> <ul> <li>Educate and supports physician documentation for appropriateness of admission and continued stay, severity, and morbidity/mortality. </li><li>Lead discussions promoting a culture of urgency and accountability around care progression. </li></ul> <p>Data, Quality and Performance</p> <ul> <li>Track and report utilization KPIs (LOS, CMI, Observation %, Denials). </li><li>Use data to drive education and continuous improvement. </li></ul> <p>St. Joseph's Health is recognized for the expertise and compassion of its highly skilled and responsive staff. The combined efforts of the organization's outstanding physicians, superb nurses, and dedicated clinical and professional staff have made us one of the most highly respected healthcare organizations in the state, the largest employer in Passaic County, and one of the nation's "100 Best Places to Work in Health Care".</p>