Centura Health

Englewood, CO

Physician Advisor - Denver / Metro

Posted 18 days ago

Job Description

Welcome to Centura Health

Welcome to Centura Health - the largest health ecosystem in Colorado and Kansas. Welcome to living your mission among thousands of people on fire to live theirs too. Welcome to options and possibility where you can chart the direction and flow of your career. Welcome to the freedom to believe in what you believe, and welcome to a family guided by shared values and a commitment to extending the healing ministry of Christ. Welcome to extremely important industry challenges and opportunities to solve complex problems. Welcome to highly intelligent teams and overflowing community. And welcome to wholeness of mind, body and spirit. Welcome to Centura Health.

You have a purpose, unique talents and NOW is the time to embrace it, live it and put it to work. At Centura Health, we value incredible people with incredible skills - but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success.

Flourishing Begins Here

Centura Health is a faith based mission driven healthcare system comprised of 17 hospitals in Colorado and Western Kansas with a focus on a high quality whole person care delivered in a physician fcing environment.

The Physician Advisor works closely with the care management team to ensure correct patient status, regulatory compliance and delivery of high quality healthcare to those we serve. Responsibilities include collaboration with leadership initiatives, work with payors and support to our clinical teams through rounding and educational efforts. The PA will use data to drive upstream solutions and identify areas of opportunity in utilization review, length of stay management and proactive discharge planning through multi-disciplinary rounds, complex care rounds and observation rounds among other efforts. This PA will provide services at or above their customary practice standards in the community and within the qualifications and experience of physicians and adhere to the standards and principles of medical ethics of the American Medical Association and all recognized associations or accrediting boards concerned with physician's area of medical specialty.

What You Bring/Job Requirements
  • 5 years experience as a physician.
  • Review escalated cases from UR team using CORTEX software
  • Conduct peer to peer discussions with payors
  • UM committee chair
  • PEPPER analysis/regulatory compliance
  • Partner with denials/appeals team for upstream solutions
  • Administrative experience on Medical Staff and Hospital Committees or administrative roles, preferred.
  • Experience as a Physician Advisor in the acute care setting and/or the payer environment, preferred.
  • Education and experience in the areas of medical management, outcomes management, and quality improvement/patient safety, preferred.
  • MD or DO from an approved college of medicine required
  • BE/BC required
  • CO medical license required
  • Certification by the American Board of Quality Assurance & Utilization Review Physicians preferred
Your Connected Community

When people and places align, incredible things happen. Just like the 21,000+ amazing associates who work here, every community within Centura Health's connected ecosystem has its own unique history, story and personality.

This role would cover both St. Anthony Hospital in Lakewood, Colorado and Avista Adventist Hospital in Louisville, Colorado.

Caring for Your Whole Well BeingWe provide whole person care and understand that a comprehensive benefits package will enrich the lives of our associates at work and at home. At Centura Health we offer exceptional benefits to eligible associates. Our total rewards are designed with your well-being in mind and may include: - 401K, which includes matching when eligible - Three Health Insurance Plan Options including covering eligible dependents - Two Dental Insurance Plan Options including covering eligible dependents - Vision Insurance including covering eligible dependents - Daycare & Medical Flexible Spending Account Options - Leaves of Absence - Short Term Disability - Long Term Disability - Life Insurance - Voluntary Benefits including Hospital Indemnity Coverage, Critical Illness, Accident, Permanent Life insurance, and Norton LifeLock - Paid Time Off - Spouse & Child/Dependent Life Insurance Coverage Options - Shift Differentials - Employee Wellness Resources - Employee Assistance Programs - Tuition Reimbursement - Shift differentials - Relocation assistance based on location - Associate Discounts for phone, cell phone plans, Auto Insurance, Home Insurance, Auto Buying, Pet Insurance, and much more... The pay rate for this position is listed above and varies based on experience, skills, and comparison to others who are already in this role. *If you do not see the pay for this position listed above or you see an estimate, it is because you are on a second party job board. Please visit www.centura.org/careers to apply and see the pay range for this role. All of our pay ranges are posted clearly on the Centura Health Careers site.*