The Physician Advisor (PA) serves as a clinical resource to the medical staff and CM/SW by providing identification, facilitation and resolution of utilization issues. The PA role has a matrix reporting structure which includes Corporate Physician Advisor and Corporate CQIO , as well as entity CMO and CEO. The Physician Advisor addresses the following issues: Federal and state compliance, documentation supporting coding/medical necessity/clinical validation, appropriate level of care, length of stay, hospital utilization and quality issues. In collaboration with admitting physician, healthcare team, and case management , the PA proactively manages cases at the point of entry and through the hospital stay , to ensure the patient is placed in the proper level of care classification based on medical necessity, severity of illness and risk of mortality . The PA ensures compliance with CMS for appropriate billing . The PA conducts post-discharge reviews related to payer audits. Promotes understanding and cooperation between the medical staff through communication, collaboration and education. Facilitate improvements in clinical practice to achieve better performance, improved cost, reduced length of stay, fewer readmissions, and superior patient care.
...Structure Resources is seeking a Safety Specialist for our client, a well-established commercial general contractor based in Indianapolis. This is an exciting opportunity to join a company with a strong reputation for delivering high-quality commercial projectsincluding...
...to offering high-quality education and training to enhance maritime safety. Role Description This is a full-time on-site Instructor Sea Rescue role located in Cape Canaveral, FL. The candidate MUST have registered sea service as an Officer. Instructor Sea Rescue...
...About the Role Insight Global is seeking a Prior Authorization Specialist to help make specialty medications more accessible and affordable. This is an onsite role in Pittsburgh, PA, where youll collaborate with specialty care clinics and our internal team to enhance...
...Description: Our Healthcare Client is seeking a detail-oriented SAP Data Specialist to join our team. This role involves accurately... ...efforts as needed Requirements: Previous experience in data entry, preferably within healthcare or SAP systems Strong attention...
...the industry. TMC can offer you a fast-paced career where each day brings a new challenge. TMC Transportation is looking for Shag Drivers to join our team, at our Dedicated customer site - Continental. Shift: Sunday-Thursday: 1030pm-7am DUTIES AND RESPONSIBILITIES...