Section Chief, Physician Advisor with Carilion Clinic VTCSOM, Roanoke Virginia

Carilion Clinic, headquartered in Roanoke, Virginia is recruiting for a full-time Section Chief, Physician Advisor to serve as the physician expert and leader for the IPA team, with direct reports of full and flex time IPAs.  This position is dyad paired with the Senior Director of System Care Management, collaborating with all levels of leadership in the system. Oversees program support for utilization management activities to include but not limited to second level reviews, peer to peer communications, level of care determination, continued stay and length of stay decisions. Functions as a consultant in resource management to the IPA team. Reinforces evidence-based medicine best practices and adheres to criteria-based guidelines in the Carilion Clinic Utilization Review Plan. Ensures the IPA team is applying consistent clinical judgement and review process outcomes to meet The Joint Commission and other accrediting agencies requirements specific to care coordination. Collaborates with Hospital Care Management and Quality department leadership to identify gaps in physician practice related to standards and regulations and develops action plans to address identified gaps in regulatory requirements. Supports the IPA team by serving as an administrative liaison between the hospital administrators, clinical staff, and support personnel in order to ensure regulatory compliance. Advises physicians on medical necessity and assists hospital leadership in meeting overall organizational goals related to providing efficient and safe patient care. This position is 80% administrative and 20% clinical.

Qualified candidates must have a degree from an accredited medical school with completion of an accredited residency and be board certified. Possess a strong clinical acumen. Knowledge of care management principles, utilization review processes and their practical application under current acute care InterQual guidelines. Working knowledge of third-party payer guidelines and commercial payer requirements of medical necessity criteria. Candidates must demonstrate excellent written and oral communication and presentation skills. Ten years recent experience in a hospital clinical practice with five years administrative/physician management. Previous experience as a Physician Advisor is required.