Physician Advisor

Houston Methodist is seeking a Physician Advisor to join their team, focusing on teaching, consulting, and advising the case management department, clinical documentation specialists, medical staff, and the hospital on medical necessity, compliance, payer relationships, physician practice patterns, documentation, and resource utilization. This role is integral to the hospital's utilization review/management committee, ensuring high-quality healthcare and cost-effectiveness. The Physician Advisor will conduct clinical reviews to support the hospital's objectives for quality patient care.

Practice Info

• Key member and leader of the hospital's utilization review/management committee
• Focus on regulatory goals of ensuring high levels of healthcare quality and acceptable levels of cost
• Conducts clinical reviews on cases referred by case management and/or other healthcare professionals

Responsibilities

• Interact with medical staff members to discuss patient needs and alternative levels of care
• Provide consultation to case management staff regarding complex clinical issues and advise on next steps
• Provide feedback to attending and consulting physicians regarding level of care, length of stay, and quality issues
• Chair the utilization review/management committee and actively participate in defining operational strategic objectives for the Utilization Management Program
• Assist with the evaluation of the hospital's Utilization Management Program, including annual review and revision of the hospital's UR plan
• Contact physicians to resolve delays and achieve positive outcomes and ensure physician accountability for efficient patient care management
• Communicate to medical staff leaders relevant findings of physician's performance when patterns of clinical outcomes demonstrate undesirable variation
• Act as consultant and resource to attending/responsible physicians regarding their decisions relative to appropriateness of hospitalization, continued stay and use of resources in length of stay management

Shift & Schedule

• Work Shift: 1 - Day

Requirements

• Graduate of accredited medical school
• Five years experience in clinical practice
• MD - Physician - State Licensure - Texas Department of Licensing and Regulation_PSV
• Unrestricted medical license in the State of Texas
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job
• Ability to effectively communicate with patients, physicians, family members and co-workers
• Ability to foster positive medical staff relations and work effectively with all healthcare disciplines
• Demonstrates understanding and knowledge of utilization management, clinical documentation, and state and federal healthcare regulations
• Active practitioner