Physician Advisor Case/Utilization Management

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HealthPark Medical Center and Lee Memorial Hospital have been awarded the highest five-star accolade, putting Lee Health hospitals in the top 15% of hospitals in the country for the second year in a row

All Lee Health hospitals received honors as Best Hospitals by U.S. News & World Report for the high-quality care they provide to the Southwest Florida community

Lee Health is honored to be the first healthcare system in Florida to be recognized with the Governors Sterling Award, granted by the Sterling Council.

Lee Health has been honored with the inaugural Pinnacle of EHR Experience Award from the KLAS Arch Collaborative, recognizing our health system's efforts to enhance the electronic health record (EHR) experience for physicians and providers. The award places Lee Health among an elite group of only 10 organizations nationwide to receive this honor.

Lee Health is seeking a Physician Advisor Peer-to-Peer!

Lee Health is a nonprofit organization with more than 18,000 employees, 4,500 volunteers, and more than 1,300 employed primary care and specialty care providers with multiple practice locations throughout Southwest Florida. The organization has four acute care hospitals and one specialty hospital that together house over 1,800 hospital beds.

Position Information:

At the Gulf Coast Medical Center, the Physician Advisor Case/Utilization Management (PA/CM UM ) is responsible for teaching, consulting, and advising the Case and Utilization Management Departments, medical staff, and others within the medical center on matters regarding medical necessity; Centers for Medicare and Medicaid Services (CMS) compliance including rules and regulations; collaboration and relationships with payers; physician practice patterns; documentation; and over- and under-utilization of resources. The PA/CM UM is a key member of Lee Healths Utilization Review Committee which is charged with regulatory goals of ensuring high levels of healthcare quality and acceptable levels of cost. They will conduct clinical reviews on cases referred by case/utilization management and/or other healthcare professionals in accordance with medical center objectives related to quality care of patients.

They will work closely with each other, the System Medical Director Physician Advisors (SMDPA), the Chief Nursing and Operations Executive Gulf Coast Medical Center, medical staff, medical residents and fellows, and other leadership related to case/utilization and revenue cycle.

The primary role of the PA/CM UM is to monitor and foster optimization of all aspects of Gulf Coast Medical Center resource management, utilization management, case management (including discharge planning), and social services for all patients while ensuring the highest quality of care is provided. This includes working with the SMDPA and Gulf Coast Medical Center leadership to ensure efficient management and delivery of resources, compliance with case management protocols to optimize length of hospital stay, effectively identify elements of medical necessity for patient placement in appropriate levels of care and patient status, support documentation integrity and compliance, and monitor the appropriate use of diagnostic and therapeutic modalities. Is an expert in Centers for Medicare and Medicaid Services (CMS) rules and regulation related to patient status, clinician documentation, medical necessity, provision of services, and other topics related to case/utilization management.

Benefit Highlights:

- Generous paid time off to enjoy the Beautiful Southwest Florida weather and beaches!

- Sign on bonus & relocation package

- Dedicated CME time and funding

- Malpractice Insurance and Tail Coverage

- 403(b) retirement plan with match and 457(b) enhanced retirement option

- Short term/long term disability

- Participation in the Federal Public Service Loan Forgiveness Program

Fort Myers:

Come live the beach/vacation lifestyle youve always dreamed of in coastal southwest Florida! We have warm weather year-round, beautiful beaches, amazing sunsets, dozens of recreational parks and ecological preserves, as well as numerous world-renowned golf courses. There are a variety of restaurants, plenty of shopping at nearby malls and outlets, art, history and a wide variety of festivals year-round. There is truly something for everyone! Plus, no state income tax!

Southwest Florida International Airport is easy to access and offers numerous direct flights and connections to meet all your travel needs. Those in this area are also able to enjoy the Key West Express which allows for a 3-hour boat ride down to Key West! Fort Myers is minutes away from Sanibel Island, Captiva, and Naples. This area is also centrally located between three of Floridas major cities: Orlando, Tampa, and Miami.

If you are interested in learning more about this opportunity, please email your CV to our Physician Recruitment Office at View email address on jobs.leehealth.org .

As a community-focused nonprofit health system in Florida, it's our mission to build a healthier future for our community.