Physician Advisor - Des Moines (on-site) - $50,000 Bonus
On-site · Des Moines, Iowa, United States
EXPIREDDes Moines, Iowa, United StatesOn-siteFull TimeSenior LevelDoctorate Or Professional DegreeLarge
Type
Full Time
Level
Senior Level
Education
Doctorate Or Professional Degree
Company size
Large
Job Summary
Lead physician-driven clinical resource utilization program; review cases to determine appropriate level of care based on medical necessity and apply regulatory, health plan, and clinical guidelines in denials reviews; serve as a resource for physicians regarding medical necessity, level of care, and clinical documentation; foster effective communication among care team; establish and maintain peer-to-peer protocol; part of MercyOne Des Moines Medical Center operations in Des Moines, IA.
Required Qualifications
- Board-certified physician
- Inpatient experience
- Strong knowledge of CMS and commercial insurance regulations
- Team-building and collaboration skills
- Experience on hospital committees
- Ability to lead clinical resource utilization programs
- Experience with medical necessity, regulatory guidelines, and clinical documentation
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