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McLeod Health
Physician Advisor for Case Management Services
Career Insights for Clinical Auditor / Utilization Reviewer
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Scorecard
Based on South Carolina data
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What they do
A Clinical Auditor or Utilization Reviewer reviews the efficiency of healthcare delivery. Individuals tend to have had experience as a registered nurse or other healthcare delivery roles before transferring into this quality review role.
$81,559 / year median in South Carolina
-7% projected decline
Job Description
Physician Advisor for Case Management Services - Florence McLeod Health is seeking a BC/BE Physician Advisor for Case Management Services at our flagship 565-bed tertiary care center. Responsibilities include, but are not limited to:
- Monday-Friday, on-site with no-call
- Provide clinical leadership and expert guidance to the case management and utilization review teams
- Educate and collaborate with medical staff on documentation, length of stay, level of care and resource utilization
- Serve as liaison between hospital and payer medical directors to resolve clinical and reimbursement issues
- Participate in quality improvement initiatives around readmission rates, mortality and compliance
- Review admissions, discharges and transfers for medical necessity per CMS and payer guidelines
- Support policy development and drive evidence-based care pathways What to expect:
- Competitive compensation, Full Benefits, Retirement, Sign on Bonus, Relocation Allowance, CME Days, CME Allowance and Paid Malpractice
- Position qualifies for PSLF (Public Service Loan Forgiveness)
EPIC EMR
- A Physician-led non-profit system that supports leadership and development growth with the McLeod Health Leadership Academy missy.