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CommonSpirit Health

Nonprofit Catholic health system providing healthcare

Physician Advisor

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-timePhoenix, AZ, USANo salary listedIn-person

About the Job

Requirements

  • Five years of clinical practice experience.
  • A Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree, with the physician licensed in Arizona.

Responsibilities

  • Promote evidence-based medical care and appropriate hospital resource utilization, facilitating communication across medical, nursing, care coordination, and administrative departments.
  • Advocate for efficient patient care, remove barriers, and collaborate with attending physicians to support the Department of Care Coordination's utilization and compliance efforts.
  • Mitigate insurance payer denials by providing valid and effective secondary medical necessity reviews.
  • Review and report performance measures, and recommend improvements to the Departments and Medical Executive Committee regarding patient care, resource utilization, billing compliance, and claims denial reduction.
  • Perform secondary medical necessity reviews to support compliance with Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (COP).
  • Provide secondary medical necessity reviews more cost-effectively than outside contracted services.
  • Align and collaborate with facility leadership.
  • Understand facility history and culture to effectively execute and implement job duties and functions.

Desired Qualifications

  • One year of experience in Utilization Management.

About the Company

CommonSpirit Health

Nonprofit Catholic health system providing healthcare

CommonSpirit Health is a nonprofit Catholic healthcare network that provides integrated health services across clinics, care sites, hospital locations, home-based services, and virtual care. Its system coordinates care across hospitals, clinics, home health, and telehealth to create a connected patient experience with teams of physicians, nurses, and providers. Unlike many players in health care, it combines a large national footprint with nonprofit, faith-based stewardship, prioritizing charity care and community benefits and focusing on equitable access over margins. Its goal is to create a healthier future for all by building a just, equitable, and accessible health care delivery system grounded in humankindness and collaboration with patients and communities.

Company size
10,001+
Company stage
Not listed
Total funding
Not listed
Headquarters
Chicago, IL
Founded
2019

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