Physician Advisor - Des Moines (on-site) - $50,000 Bonus
On-site · Des Moines, Iowa, United States
Job Summary
Lead physician-driven clinical resource utilization program for MercyOne Des Moines Medical Center as a Physician Advisor. Responsibilities include reviewing cases to determine appropriate level of care based on medical necessity and applying regulatory, health plan, and clinical guidelines in denials reviews; serving as a resource for physicians regarding medical necessity, level of care, and clinical documentation; fostering effective communication within the care team; and establishing/maintaining peer-to-peer protocol. On-site role based in Des Moines, IA. Describes MercyOne Central Iowa system and its wide network, with emphasis on physician training and program growth in oncology care strategy within Central Iowa.
Required Qualifications
- board-certified physician
- inpatient experience
- served on hospital committees
- strong working knowledge of CMS regulations
- strong working knowledge of commercial insurance regulations
- team-building mindset
- collaborative approach to decision making
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