Full-Time Physician Advisor Opportunity in Chattanooga, TN

Erlanger, located in Chattanooga, TN is a nationally-acclaimed, multi-hospital health system anchored by a leading academic medical center. Each year, more than 1,000,000 people are treated by a team of healthcare professionals who are part of Erlanger. This position is for a full-time Physician Advisor. While we are open to this being a remote position, the ideal candidate will live within the Chattanooga, TN area or able to commute when needed for meetings and such.

• Participate in peer-to-peer discussions with managed Medicaid, managed Medicare and commercial insurance medical directors.
• Provide subject matter expert guidance regarding utilization management activities that involve admission status, medical necessity, CC44, OC72, the two-midnight rule, etc. This guidance will be supported by clinical evidence and will be compliant with applicable governmental rules and regulations.
• Work with IT to ensure logical processes, best practices, and compliance with CMS regulations.
• Promote professional development of the UM staff with a focus on compliant patient status assignments, consistent use and documentation of primary screening criteria (MCG/lndicia), knowledge of the most recent IPO procedure list, IPPS and OPPS annual changes and how they impact status determination, charges, reimbursement, and interrater reliability of the Physician Advisors.
• Work collaboratively with Revenue Integrity to reduce denial and appeal burdens and increase revenue by improving the accuracy of initial patient status determinations.
• Interface with Compliance as a subject matter expert for government regulations and annual audits.
• Assist with the development and driving of improvement initiatives including providing feedback to medical staff regarding utilization management determinations.
• When available, participate in IDR (interdisciplinary rounds) to advise on the improvement of clinical resource utilization and throughput.
• Assist with training of all new UM department hires.
• Perform such other duties as reasonably requested by Erlanger or otherwise necessary to properly assist in the operations of assigned areas.

Benefits of Working at Erlanger Health System

• Excellent Compensation & Benefits Package
• Sign-On Bonus & Relocation Available, Loan Repayment
• Malpractice Coverage Provided
• Teaching Affiliation-  UT College of Medicine
• Clinical Affiliation- Vanderbilt University
• 10 Residency Programs & 10 Fellowship Programs
• Largest Employed Medical Group in region
• Low Cost of Living
• 91 miles from Chattanooga, TN
• 111 miles from Asheville, NC
• 118 miles from Atlanta, GA