Anesthesiology Physician
Company: CommonSpirit Health
Location: Sacramento
Posted on: October 19, 2024
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Job Description:
Overview
CommonSpirit Health was formed by the alignment of Catholic Health
Initiatives (CHI) and Dignity Health. With more than 700 care sites
across the U.S. from clinics and hospitals to home-based care and
virtual care services CommonSpirit is accessible to nearly one out
of every four U.S. residents. Our world needs compassion like never
before. Our communities need caring and our families need
protection. With our combined resources CommonSpirit is committed
to building healthy communities advocating for those who are poor
and vulnerable and innovating how and where healing can happen both
inside our hospitals and out in the community.
Responsibilities
This is a remote position. Summary The Utilization Management
Physician Advisor II conducts clinical case reviews referred by
case management staff and/or other health care professionals to
meet regulatory requirements and in accordance with the hospital's
objectives for assuring quality patient care and effective and
efficient utilization of health care services. This position will
be a part of the specialized Denials Management team. This
individual meets with case management and health care team members
to discuss selected cases and make recommendations for care as well
as interacting with medical staff members and medical directors of
third- party payers to discuss the needs of patients and
alternative levels of care. T he PA performs denials management and
prevention in accordance with the organization's goals and
expectations. This individual reviews cases for medical necessity,
clinical validation, performs peer-to-peer discussions and
participates in appeal letter writing. The PA acts as a consultant
to, and resource for, attending physicians regarding their
decisions relative to appropriateness of hospitalization, clinical
documentation, continued inpatient stay, and use of healthcare
resources. The PA further acts as a resource for the medical staff
regarding federal and state utilization and quality regulations.
The PA helps facilitate training for the physicians. The PA must
demonstrate interpersonal and communication skills and must be
clear, concise and consistent in the message to all
constituents.
Key Responsibilities
Required:
Pay Range
$88.46 - $141.54 /hour
Keywords: CommonSpirit Health, Fremont , Anesthesiology Physician, Healthcare , Sacramento, California
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