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For Companies At a Glance
- Tasks: Coordinate patient care and improve quality metrics in a dynamic healthcare environment.
- Company: Join Beebe, a vibrant healthcare team dedicated to excellence in patient care.
- Benefits: Enjoy a fulfilling career with opportunities for professional growth and community impact.
- Why this job: Make a difference in patient health while collaborating with a passionate team.
- Qualifications: Must have an MD or DO, with 5-7 years of direct patient care experience.
- Other info: Board certification in a medical specialty is preferred; competitive salary offered.
The predicted salary is between 100000 - 185000 £ per year.
Why Beebe?
Become part of the Beebe team – an inclusive team positioned in a vibrant, coastal community. Enjoy a fulfilling career as you support the health of our patients and a team focused on excellence.
Overview
The Utilization Review Physician is responsible for coordinating between case management, discharge planning, utilization review, coding team, physicians, providers, coding team, population health, and other clinical members to assist in providing cost efficient, high quality inpatient care for observation and inpatients at Beebe Medical Center facilities. This position includes assisting in policies, processes, and education around improving Patient Care and Quality metrics including although not limited to Length of Stay, cost reduction, appropriate coding, and appealing denials as appropriate.
The Utilization Review Physician will work in a dyad leadership with the Utilization Review and Case Management Leadership. Will directly report to Beebe Healthcare\’s Physician In Chief.
Responsibilities
Maintains accountability for achieving favorable case management outcomes.
Supports the medical staff in the efficient progressions of patient care.
Reviews issues identified by case managers, utilization review to ensure appropriate follow-up and recommends improvement initiatives as needed.
Provides consultation to the clinical team around complex clinical issues, Social Determinants of Health and advises on future action.
Works to optimize quality of care and cost of care with direct involvement with Hospitalists and other clinical sections.
Works with clinical team to optimize patient and team member satisfaction.
Participates in developing and maintaining positive relationships with Medical Directors of third-party payers.
Resolves status concerns: CODE 44/ HIMM letters. Participates in level of care determinations on a case-by-case basis as requested by case managers. Evaluates and responds to denials of payment.
Will co-facilitate the Utilization Review Committee.
Collaborates with coding team to educated and optimize appropriate coding and modifiers.
Collaborates with other services such as Risk Management, Palliative Care, as needed.
Works with Beebe Medical Center Hospitalist Program, specifically working with Medical Director and team to educate and optimize utilization, coding, and quality goals.
Qualifications
Board eligibility of Board Certification in a Medical Specialty or Sub-Specialty.
M.D. or D.O. medical degree.
Minimum of 5-7 years in direct patient care.
Active or pending certification in Health Utilization Review
Competencies Skills
\”Essential:* Clear Communication Skills Both Written And Verbal* Able To Keep Confidential Information Regarding Patients, Team Members* Able To Withstand Crisis Situations* Has Skills To Provides Customer Service To Patients, Team Members And Visitors* Knowledge And Experience With Electronic Health Records\”
Credentials
Education
Essential:* Doctor of Medicine (MD)
Other Information
Board eligibility of Board Certification in a Medical Specialty or Sub-Specialty.
M.D. or D.O. medical degree.
Minimum of 5-7 years in direct patient care.
Active or pending certification in Health Utilization Review
Entry
USD $0.00/Hr.
Max
USD $165,949.00/Yr. #J-18808-Ljbffr
CASE MGMT - PHYSICIAN ADVISOR employer: Beebe Healthcare
Contact Detail:
Beebe Healthcare Recruiting Team
StudySmarter Expert Advice 🤫
We think this is how you could land CASE MGMT - PHYSICIAN ADVISOR
✨Tip Number 1
Network with professionals in the healthcare field, especially those involved in case management and utilisation review. Attend relevant conferences or workshops to meet potential colleagues and learn more about the industry.
✨Tip Number 2
Familiarise yourself with Beebe Medical Center's values and mission. Understanding their focus on patient care and community involvement can help you align your discussions during interviews with their goals.
✨Tip Number 3
Prepare to discuss specific examples from your past experience that demonstrate your ability to improve patient care metrics and manage complex clinical issues. This will show your potential value to the team.
✨Tip Number 4
Stay updated on the latest trends and regulations in health utilisation review and case management. Being knowledgeable about current practices will help you stand out as a candidate who is proactive and informed.
We think you need these skills to ace CASE MGMT - PHYSICIAN ADVISOR
Some tips for your application 🫡
Tailor Your CV: Make sure your CV highlights relevant experience in case management and utilization review. Emphasise your medical qualifications, years of direct patient care, and any specific achievements related to improving patient care metrics.
Craft a Compelling Cover Letter: Write a cover letter that showcases your passion for patient care and your understanding of the role. Mention how your skills align with Beebe's mission and values, and provide examples of how you've successfully navigated complex clinical issues in the past.
Highlight Relevant Skills: In your application, focus on essential skills such as clear communication, crisis management, and customer service. Provide specific examples of how you've demonstrated these skills in previous roles, particularly in relation to case management and collaboration with clinical teams.
Proofread Your Application: Before submitting, carefully proofread your application materials. Check for spelling and grammatical errors, and ensure that all information is accurate and clearly presented. A polished application reflects your attention to detail and professionalism.
How to prepare for a job interview at Beebe Healthcare
✨Understand the Role
Make sure you have a solid grasp of what the Utilization Review Physician does. Familiarise yourself with the responsibilities outlined in the job description, such as coordinating between various teams and improving patient care metrics.
✨Showcase Your Experience
Prepare to discuss your past experiences in direct patient care and how they relate to the role. Highlight any specific instances where you've improved patient outcomes or navigated complex clinical issues.
✨Demonstrate Communication Skills
Since clear communication is essential for this role, be ready to provide examples of how you've effectively communicated with medical staff, patients, and other stakeholders in previous positions.
✨Prepare Questions
Have thoughtful questions ready for your interviewers. This could include inquiries about the team dynamics, challenges faced in the role, or how success is measured within the Utilization Review department.
