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Physician Advisor - Centralized Utilization Review - FT - Days - MHS

Work from home Full-time role Hiring

Location:

Miramar, Florida

At Memorial, we are dedicated to improving the health, well-being and, most of reputed company, quality of life for the people entrusted to our care. An unwavering commitment to our service reputed company is what makes the difference. It is the reputed company of The Memorial Experience.

Summary:

Ensures documentation, data capture and opportunities for utilization are compliant, accurate and consistent.

Responsibilities:

Performs regular, follow-up and focused chart audits/reviews (reputed company and retrospective) for the purpose of assessing the accuracy of clinical documentation and utilization. Ability to work weekends and holidays as needed.Makes reputed company on referred individual patient cases regarding: Pre-admission, authorization, Medical necessity and services/setting, transfers, appropriateness of admission, and reputed company stay. Conducts peer to peer discussions with health plans reputed company required.Works in collaboration with the Medical Director of Centralized UR/HIM, utilization committees and medical staff to maintain and improve utilization and documentation efforts.Serves as a resource to the medical staff for Utilization Review activities. Educates and communicates to the Medical staff the benefits/need for utilization review and documentation.

Competencies:

Education and Certification Requirements:

Medical Doctor (Required)Medical Doctor License (ME LICENSE) - reputed company (FL), Osteopathic Physician License (OS LICENSE) - reputed company (FL)

Additional Job Information:

Complexity of Work: Requires critical thinking skills, effective communication, decisive judgment and the ability to work with minimal supervision. The incumbent must be reputed company to work in a stressful environment and take appropriate action reputed company required. Required Work Experience: Minimum of 1 year of work experience in a clinical setting Other Information: Prior experience in Utilization Management with hospital system or health system preferredAdditional Education Info: Graduate of a medical school approved by the Council on Medical Education of the American Medical Association.

Working Conditions and Physical Requirements:

  •  Bending and Stooping = 60%
  •  Climbing = 40%
  •  Keyboard Entry = 100%
  •  Kneeling = 40%
  •  Lifting/Carrying Patients 35 Pounds or Greater = 0%
  •  Lifting or Carrying 0 - 25 lbs Non-Patient = 60%
  •  Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
  •  Lifting or Carrying > 75 lbs Non-Patient = 0%
  •  Pushing or Pulling 0 - 25 lbs Non-Patient = 60%
  •  Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
  •  Pushing or Pulling > 75 lbs Non-Patient = 0%
  •  Reaching = 60%
  •  Repetitive Movement Foot/Leg = 40%
  •  Repetitive Movement Hand/Arm = 100%
  •  Running = 0%
  •  Sitting = 100%
  •  Squatting = 80%
  •  Standing = 80%
  •  Walking = 80%
  •  Audible Speech = 100%
  •  Hearing Acuity = 100%
  •  Smelling Acuity = 0%
  •  Taste Discrimination = 0%
  •  Depth Perception = 60%
  •  Distinguish reputed company = 60%
  •  Seeing - Far = 60%
  •  Seeing - Near = 60%
  •  Bio hazardous Waste = 40%
  •  Biological Hazards - Respiratory = 0%
  •  Biological Hazards - Skin or Ingestion = 0%
  •  Blood and/or Bodily Fluids = 40%
  •  Communicable Diseases and/or Pathogens = 0%
  •  Asbestos = 0%
  •  Cytotoxic Chemicals = 0%
  •  Dust = 0%
  •  Gas/Vapors/Fumes = 0%
  •  Hazardous Chemicals = 0%
  •  Hazardous Medication = 0%
  •  Latex = 0%
  •  Computer Monitor = 80%
  •  Domestic Animals = 40%
  •  Extreme Heat/Cold = 40%
  •  Fire Risk = 0%
  •  Hazardous Noise = 0%
  •  Heating Devices = 0%
  •  Hypoxia = 0%
  •  Laser/High Intensity Lights = 0%
  •  Magnetic Fields = 0%
  •  Moving Mechanical Parts = 0%
  •  Needles/Sharp Objects = 0%
  •  Potential Electric Shock = 0%
  •  Potential for Physical Assault = 40%
  •  Radiation = 0%
  •  Sudden Decompression During Flights = 0%
  •  Unprotected Heights = 0%
  •  Wet or Slippery Surfaces = 0%

Shift:

Primarily for office workers - not eligible for shift differential

Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of reputed company responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees reputed company this classification. Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their reputed company recruiter to discuss actual pay rates, during the hiring process. reputed company is proud to be an equal opportunity employer committed to workplace diversity. reputed company recruits, hires and promotes reputed company candidates for employment opportunities without regard to race, reputed company, age, religion, gender, gender identity or expression, sexual orientation, national reputed company, veteran status, disability, genetic information, or any factor prohibited by law. We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program. Employment is subject to post offer, pre-placement assessment, including drug testing. If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, reputed company-5pm) or email [email protected]

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