NorthShore University HealthSystem (NorthShore), the principal academic affiliate of the University Of Chicago Pritzker School Of Medicine, seeks Physician Advosors for Care Management and Documentation Integrity in order develop, implement and oversee hospital bed and related resource utilization, patient throughput, and documentation at NorthShore University Health System.
Essential Functions and Responsibilities
- Oversee appeals and denials and write- off management in conjunction with the appropriate administrative leadership (CDI, Compliance, Care Management, Revenue Cycle). Areas of focus may include medical necessity denials, DRG change denials, and other external audit feedback requiring medical leadership’s response.
- Work with the CDI team to develop and implement ongoing documentation education to hospital based providers, reaching out to physicians who do not respond timely to documentation queries.
- Support and/or develop efforts to use technology based solutions in our EMR to further documentation capture of accurate coded data.
- Determine and arbitrate level of care determinations. Should Physician Advisor identify need for clarification and/or additional documentation by Attending Physician and/or consultant(s), Physician Advisor shall independently, or in cooperation with Case Manager or CDI, seek clarification or additional documentation by following established query process Physician Advisor may elect to personally contact the Attending Physician and/or consultant(s) to discuss any documentation, pathophysiology, or utilization issues.
- Work with patient placement office and emergency departments to educate, translate and enforce the admission process for all patients, regardless of the site or pathway of entry.
- Provide ongoing education on capacity management, utilization review, discharge process and resources to all house staff and attending staff on a regular basis. Work with physicians, individually and in groups, on admission and discharge patterns.
- Assist in the admission and discharge process as necessary. Engage in physician-to-physician communication to provide just-in-time education and resolve conflicts.
- Work with the Admission office to assure that patients are assigned beds at the right level of care from the outset.
NorthShore University HealthSystem (NorthShore) is a four-hospital, fully integrated health system that offers leading clinical care and is supported by the nation’s top ranked electronic health record system. Become a member of a 900+ physician, multispecialty group practice that includes more than 100 plus office locations with over 2,400 affiliated physicians. NorthShore is a comprehensive, fully integrated, healthcare delivery system that includes four hospitals – Evanston Hospital, Glenbrook Hospital, Highland Park Hospital and Skokie Hospital.
We offer a competitive compensation and benefits package, a highly collegial work atmosphere, and an opportunity to work with a world-class interdisciplinary team of medical professionals.