Community Medical Center, an affiliate of RWJBarnabas Health System, is a 592-bed, fully accredited acute care hospital offering area residents world-class medical treatment with the comforts of hometown care. Opened in 1961, CMC has evolved into the state s largest non-teaching hospital and Ocean County s largest and most active healthcare facility caring for over 24,200 inpatients, 142,500 outpatients and 81,400 emergency department patients each year.
In this role, the Physician Advisor will work in collaboration with the Chief Medical Officer is responsible for providing medical leadership for administering the facility s utilization management program. This individual will act as a liaison between the leadership, medical staff, case management staff, payers, and managed care organizations, to support the efficient use of resources for inpatients and the coordination of services during transitions of care to the community.
Work location: Acute care hospital, onsite work schedule required.
Position requirements: Current NJ license as MD, or DO. Respected for clinical practice with a minimum of five (5) years clinical practice. Minimum one (1) year experience as a Physician Advisor required. Participated in successful collaborative projects, or multidisciplinary committees. Experience in acute care case management-related functions is preferred.
Background experience required: Understands and applies knowledge of medical necessity criteria, managed care business models, billing guidelines, risk arrangements, peer review, performance profiling with data, outcome management strategies, level of care and compliance regulations. Possesses Utilization-specific training from ABQAURP (The American Board of Quality Assurance and Utilization Review Physicians), ACPE (American College of Physician Executive's Physician in Management course), or CPUR (Certification Program in Utilization Review), Institute for Healthcare Improvement courses, Milliman, McKesson, or equivalent may be an asset. Uses Informal and formal teaching methods. Demonstrates excellent communication skills with meetings, taskforces, and individuals. Applies diplomacy, negotiation and conflict resolution skills.
At Community Medical Center, you will find a progressive healthcare organization offering a comprehensive array of wellness and medical services including world-class cancer, diabetes, emergency, and cardiac care. We are one of the area s most trusted providers of maternal and child health services, offering superior obstetric services, a Level 2 special care nursery, and a dedicated pediatric unit. We maintain award-winning centers of excellence for women, children and seniors. The centers offer support groups in addition to fitness and wellness programs, to enhance the overall health of every member of our community.