Physician Advisor

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference

The Opportunity:

I. Job Summary

Render compliant Status determinations for hospitalized patients.

Perform peer to peers with payors’ medical directors.

Serve as subject matter expert for all issues pertaining to Physician Advisory.

II. Job CompetenciesLeadership Decision Making - Makes day-to-day leadership decisions by securing and comparing information from multiple sources to identify issues; commits to an action after weighing alternative solutions against important criteria; effectively communicates decisions to the appropriate people and teams and holds them accountable. Drives results.Coaching & Building Talent - Achieves results through other leaders by empowering them and providing feedback, instruction and development (coaching the coach) to develop their own associates; plans and supports the growth of individual skills and abilities in preparation for their next role (building bench); focuses on retention of high performers.Delegation - Successfully shares authority and responsibilities with others to move decision making and accountability downward through the organization while accomplishing strategic priorities; maintains personal ownership of outcomes without excessive involvement.Leading Teams - Inspires and sustains team unity and engagement by developing, motivating, and guiding the team to achieve results together through productive relationships and work.Executive Communication - Clearly and succinctly conveys information and ideas; communicates in a focused and compelling way that captures and holds others’ attention (appropriate, impactful, and clear).Program/Project Management - Demonstrates high accountability and responsibility for projects and programs from inception through completion/implementation; manages budget and resource planning and awareness to ensure maximized output, reduced waste and exceptional results.III. Essential Job Functions

Status determinations for hospitalized patients

Perform peer to peers with payors’ medical directors

Short inpatient stay reviews

Review observation patients daily

Build relationship with medical staff and leadership to get their buy-in with UM issues

Attend UM Committees as subject matter expert

Assist with denials and appeals as appropriate

Educate medical staff on UM topics

Partner with UR nurses, IA staff, and Case Management to maintain and improve upon the UM process

Track denial trends to assist the team evolve to meet new payor challenges

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.

IV. Employment QualificationsLegally Required License / Certification (Ex: MD, RN, LPN, etc.) ONE CERTIFICATION PER FIELDHold and maintain an unrestricted medical license in the state of the facility / clientEnsemble Required License / Certification (Ex: CRCR) ONE CERTIFICATION PER FIELDMember of the American College of Physician Advisors (ACPA) ## Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, inc. (ABQAURP) ## Physician Advisor Sub-specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQAURP)

Or other approved job relevant certification.

Desired Work Experience

Job ExperiencePeople Leadership Experience

Desired Education

Education Level Preferred Area of Study

Post Graduate Degree or Equivalent ExperienceOther Preferred Knowledge, Skills and Abilities Graduate Degree (Masters)Post Graduate Degree (Ph.D)Minimum Years and Type of Experience: Previous managed care medical doctor experience Possess or acquires a solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety Possess a working knowledge of (Hospital) organization & Case Management operations and administrative standards and policies Strong computer skills and working