Dignity Health, one of the nation’s largest health care systems, is a 22-state network of more than 9,000 physicians, 63,000 employees, and 400 care centers, including hospitals, urgent and occupational care, imaging and surgery centers, home health, and primary care clinics. Headquartered in San Francisco, Dignity Health is dedicated to providing compassionate, high-quality, and affordable patient-centered care with special attention to the poor and underserved. In FY17, Dignity Health provided $2.6 billion in charitable care and community services. For more information, please visit our website at www.dignityhealth.org. You can also follow us on Twitter and Facebook.
The incumbent will be facilitating communication between the Department of Care Coordination, Medical Staff and Administration regarding systems based practice, regulatory and quality considerations in the delivery of medical care .The incumbent advocates for, supports, and enhances the clinical credibility of the Department of Care Coordination’s utilization and compliance activities. The incumbent is responsible for the timely prospective, concurrent, peer to peer or retrospective review of resource use in referred cases, with the objective of reducing length of stay, avoidable days, or claim denials .This position also serves as a clinical resource for Care Coordinators by determining the appropriateness of the referrals, applying professional judgment in the context of patient related variables, and consulting with attending physicians, residents and other health professionals as needed in order to clarify issues regarding appropriateness of level of care, care alternatives, and resource utilization. In addition, the incumbent provides education and acts as a resource to medical staff colleagues regarding best practices, the utilization review process, regulatory issues, and the use of clinical guidelines and alternative levels of care. This position chairs and directs the activities of the hospital’s Utilization Management Committee.
The incumbent reviews and reports performance measures and makes recommendations to Departments and the Medical Executive Committee regarding opportunities for improvement of patient care, resource utilization and reduction of denials for care provided. The incumbent participates in clinical process redesign and implementation (clinical pathway/algorithm development/standing order sets, clinical program development) .The incumbent performs the duties of this role according to the organizational objectives, hospital policies, standards of practice and Federal and State regulations.
The Physician Advisor plays a critical role in promoting the highest standards of medical care while maintaining the most effective utilization of hospital resources.
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