Presence is exceptional care that delivers exceptional outcomes. We would like to invite you to share that gift as our new Physician Advisor at SSM Health - Illinois. We are seeking a well-rounded Physician Advisor who has the proven ability to engage with their medical staff and hospital leadership and who share our dedication to exceptional care and outcomes.
In addition to being a strong leader and providing support and leadership to the Regional Chief Medical Officer across our Good Samaritan Hospital in Mt. Vernon, Illinois and St. Mary's Hospital in Centralia, Illinois the Physician Advisor will:
The Physician Advisor directly affects hospital reimbursement, CMI, and other utilization metrics through supporting case management, close relationships with medical staff, communication and knowledge of payer practices, and responsibility for hospital utilization metrics.
The ideal candidate will possess strong leadership skills that will play a key role in impacting the rate of observation versus inpatient care.
Review referred medical records and addresses the clinical theory of diagnosis for admission status, continued stay and in coordination of written appeal letters to payors.
Work with the denials/appeals team in concurrent chart review to assess denials and appropriate levels of care.
Daily concurrent chart review on an “as needed” basis by the Case Managers to review current treatment plans, identify unnecessary delays in care, and assist the case managers in facilitating care with the health center and functioning as a liaison to the attending physicians in order to provide the highest quality of care in the most efficient manner possible.
Participates in CDMP program, and addresses any cases referred by the Clinical Documentation Specialists.
Hold and maintain an unrestricted medical license in the state of Illinois
Meet the requirements (and become a member) of the Hospital medical staff
Strong computer skills and working knowledge of the EPIC EMR
SSM Health is more than one of the largest Catholic, non-profit, integrated health care systems in the Midwest. We are a healing ministry of more than 11,000 providers and 38,000 professionals practicing with one shared purpose:
Through our exceptional health care services, we reveal the healing presence of God.
Here visionary leaders and talented physicians and providers work together, unified by this Mission, to make a difference in the lives of patients. Together, we are able to maximize our collective knowledge to pursue advancements in medicine and expand our ability to deliver exceptional care with faith, humanity and compassion.
Located at the Crossroads of Interstate 57 and Interstate 64 in Southern Illinois the area provides a great ability to establish a balanced professional and personal lifestyle with our outstanding schools, abundant recreation and mild climate. Located only one hour from Downtown St. Louis, Missouri, enjoy a great area with 4 seasons, longs springs and falls and mild winters. Mt. Vernon is a growing and expanding community that serves as a hub of employment, entertainment and shopping for surrounding counties. Benefit from strong public ...and private schools including a new $74 million, 315,000 sq. foot high school that opened in August of 2016.
Enjoy outdoors or the Arts? Rend Lake Recreation Area, located 15 minutes from Mt. Vernon, includes over 20,000 acres of public land, 19,000 acres of lake water with 27 boat ramps, bike trails and hunting and fishing. Prefer taking in the Arts? Cedarhurst Center for the Arts, an 85-acre estate featuring the Museum which displays changing art exhibits, an outdoor sculpture park, performing arts center, dinner theatre, concerts, art classes and craft show. Or travel the wine trail to sample some of the Award-winning local vineyards, plus enjoy yearlong music festivals & art fairs.
To learn more about our organization’s Mission, more than 24 hospitals, 10,000 providers, and 40,000 professionals visit: