Physician Advisor (CMO Administration) - 132731

UC San Diego Health is searching for a collaborative, knowledgeable, data-driven, and innovative Physician to join its Physician Advisor team. The ideal candidate will have strong communication skills to partner with other physicians, care managers and members of the inter-professional team to ensure that care is being delivered in the appropriate setting, at the appropriate time and offer facilitation/resolution to issues related to the appropriate utilization of health system resources. The Physician Advisor will work at the individual case level, the aggregate level and will be facile with the EHR. They will contribute to development of optimal hospital flow, safe transitions of care and the overall mission of UC San Diego Health. In order to manage utilization effectively, the PAs will fully understand the complexities of billing and coding and also assist in resolution of charity care and clinical overrides requests. The Physician Advisor portion of the candidate's total appointment is required to be 50-80% while the remaining effort will be comprised of the candidate's clinical specialty. The Physician Advisor program reports up through the Office of the Chief Medical Officer.

Additional responsibilities for the role includes:

* In compliance with CMS, provide second level review for Care Managers by providing guidance on admission status and ongoing care utilizing guidelines, medical decision making and best practice

* Serve as resource, liaison, and provides guidance to other physicians regarding admission status, appropriate utilization of hospital resources, transition of patients with barriers to discharge

* Provide leadership of utilization management functions

* Serve as an expert on clinical criteria (Milliman / InterQual / other guidelines)

* Act as a liaison to medical staff

* Support patient flow

* Perform chart audits

* Provide coaching and education to physicians regarding clinical documentation

* Work collaboratively with the inter-professional team within the University of California and outside agencies to achieve desired outcomes

* Provide education to medical staff on topics relating to utilization management, compliance, and accurate and specific medical record documentation

* Weigh in on the development and deployment of the strategic plan for the program; help to evolve the PA program, as appropriate, to meet enterprise needs

• Must be a CA licensed M.D./D.O. or will obtain CA M.D./D.O. licensure within 6 months of hire

• A minimum of five (5) years in medical practice, exclusive of post-graduate training

• Board Certification in primary clinical specialty

• BART or BLS at time of hire with commitment to get BART w/in 6 months of hire date

• Previous experience working within an Academic Medical Center

• Previous experience as a physician advisor

• Previous experience with clinical documentation improvement (CDI)

• Have an American College of Physician Advisors Certification (ACPA-C)

• Employment is subject to a criminal background check and pre-employment physical