Chief Physician Advisor

ORGANIZATION

Parkland Health & Hospital System (www.parklandhospital.com), located in Dallas, Texas is one of the largest public hospital systems in the country with 770 staffed adult inpatient beds and 65 NICU beds. While we prepare to move into a new state of the art facility in 2015, we are undergoing exciting changes and consequently seeking leaders who are capable of implementing changes that ensure our practices and quality of care meet the highest standard expected by the citizens of Dallas and the surrounding counties.

Founded in 1894 we serve as the primary teaching hospital for the University of Texas Southwest Medical Center; generate $1.5B in annual revenue; employ almost 9,000 employees; hold Level I status for our Trauma Center with 200K annual visits to our ED; and Level III for Neonatal ICU. In addition we have 12 community-based clinics and conducting one of the largest hospital construction projects in the country: a state-of-the- art, $1.27B, 2.5M sg. ft. replacement hospital with anticipated completion in 2014 - (http://newparkland.parklandhospital.com) and a video presentation can be found at: http://www.youtube.com/watch?v=euRMGpsyDms

PRIMARY PURPOSE

Reporting directly to the Chief Medical Officer this key individual will be responsible for a collaborative partnership with administration, the medical staff, and the leadership and staff of Care Management, and the Director of Clinical Resource Management. You will provide leadership to the Physician Advisor Department, Utilization Management Committee and medical staff to meet licensure, quality, utilization management and best practice goals to ensure high quality patient outcomes.

Selected expectations for this individual include:

1. Provides second level reviews for medical necessity denied cases, as requested by the Care Management department, to evaluate appropriateness of admission or continuing stay, utilizing standard published criteria adopted by hospital as guidelines, and applying professional judgment and patient specific variables. 2. Represents Physician Advisors on the following committees: a. Quality Improvement Council b. Utilization Review Committee (serves as Chair) c. Value Analysis Committee d. Medical Executive Committee e. Other committees as assigned 3. Responsible for meeting Chief Physician Advisor scorecard benchmarks. 4. Serves as a member of Care Management Leadership and the primary liaison between the departments(s) and hospital medical staff to ensure the provision of cost effective care to include but not limited to: a. Leads the development of hospital utilization management criteria b. Assists with denial process, review of individual cases, follow-up with physicians and payor medical director c. Assists with identifying avoidable days and high resource utilization and addresses issues with individual physicians d. Formulates medical necessity appeal letters

5. Provides oversight of physician advisor program. Ensures that assigned employees receive opportunities to further their knowledge. Incorporates best practices criteria for staff. Reports activities to UMC (Utilization Management Committee). Holds Physician Advisors responsible for scorecard benchmarks. 6. Functions as physician champion for the hospital’s Clinical Documentation Improvement department which reviews cases for all payers and all clinical services. 7. Participates in clinical process design (clinical pathways), algorithm development and medical management program development at the unit, division and system level. Participates in the implementation of strategic initiatives. Incorporates best practices when developing strategies. 8. Stays abreast of the latest developments and obtains eight (8) hours continuing education credits annually in areas of responsibility to include utilization management, coding, documentation improvement and licensure and management. Integrates knowledge gained into current work practices.

MINIMUM SPECIFICATIONS

Education: • Must have a Doctor of Medicine or Doctor of Osteopathy degree from an approved College of Medicine/Osteopathy.

Experience: • Must have five years of experience as a physician in case management or utilization management to include two years of administrative background as a physician manager. • Prefer experience in medical management, outcomes management, and quality improvement/patient safety.

Certification/Registration/Licensure: • Must be Board Certified/Eligible physician licensed for the practice of medicine in the State of Texas. • Prefer certification by American Board of Quality Assurance & Utilization Review Physicians (ABQAURP).

Skills or Special Abilities: • Must be capable of preparing and delivering thoughtful presentations to various hospital clinical departments on clinical documentation. • Essential to demonstrate the ability to develop positive productive working relationships with clinical and administrative colleagues. • Expected to be recognized by peers as an expert clinician and utilization management provider. • Must be objective, flexible and tactful in dealing with sensitive medical staff issues, practice patterns, clinical resource utilization including conflict management. • Critically necessary to demonstrate strong computer skills and working knowledge of admission and discharge criteria such as Interqual and Milliman are required along with a solid foundation in MS-DRG, APR, DRG, AP-DRG systems and ICD-9-CM.

• Must have excellent written and verbal communication skills to include physician to physician communication.

For confidential consideration please contact Mike Boate, Executive Recruiter – Parkland at [email protected]