Job Details

Overview

Hackensack Meridian Health is seeking multiple physician advisors for our hospital Case Management Department at Jersey Shore University Medical Center in Neptune, NJ.  The Physician Advisor is a key member of the healthcare organization’s leadership team and is charged with meeting the organization’s goals and objectives for assuring the effective and efficient utilization of health care services.

The physician advisor provides physician support and leadership to the utilization and resource management areas of care management including mentoring/coaching Utilization Review Coordinators/Care Coordinators, reviewing cases for medical necessity, collaborating with physicians, house staff, hospitalists in determining appropriate inpatient versus outpatient/observation status, and participating in denial and appeal processes.  The physician advisor will act as a member of the Utilization Review Committee, provide assistance to Clinical Documentation Specialists, act as a liaison to EHR/IT systems to support best practice medicine, oversee the function and performance of the observation unit, and proactively educate residents, hospitalists, and attending physicians in preventing denials and determining appropriate levels of care for patients.  The physician advisor will also identify and address issues related to throughput, efficiency, length of stay, resource utilization, readmission avoidance, quality, safety, and patient satisfaction primarily through the performance of multi-disciplinary rounds. 

This is an administrative position and the successful candidate will form a collaborative partnership with the hospital administration, the medical staff, and the case management department leadership and staff.  This partnership will provide a comprehensive clinical resource management program that includes utilization management, progression of care management, social work services, and complex discharge planning.

Highlights include:

• Full-Time Medical Director Position
• Robust Benefits and Competitive Compensation Packages

Qualifications

• Qualifications:

  • Board Certified/Board Eligible and Valid NJ License
  • Minimum of 5 years of Clinical Practice Experience
  • Previous Utilization Management Experience in Acute Care Setting Preferred
  • Knowledge of CMS Regulations and Knowledge of Nationally Accepted Guidelines such as MCG and InterQual Preferred
  • Excellent Communication and Interpersonal Skills
  • Proficient Computer Skills
  • Strong Organizational Skills with Ability to Multi-task and Set Priorities.
  Hackensack Meridian Health is a leading not-for-profit health care network in New Jersey offering a complete range of medical services, innovative research, and life enhancing care aiming to serve as a national model for changing and simplifying health care delivery.  It is an

Our Network

As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.