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CHRISTUS Mother Frances Hospital - Tyler

Physician Advisor - Care Management & CDI

Roles and Responsibilities Overview
The Physician Advisor-Care Management and Clinical Documentation Improvement (PACM) is a full-time administrative physician role serving Mother Frances Hospital -Tyler (MFH-T) and its affiliates through teaching, consulting, and advising both the Care Management Department and the medical staff on matters regarding physician practice patterns, documentation, over- and under-utilization of resources, medical necessity, compliance rules and regulations, collaboration and relationships with payers, and the community. The PACM also ensures physician support and execution for the Care Management and CDI Departments' initiatives by promoting effective and efficient physician documentation to support the patient's Level of Care (LOC), billing status, and appropriateness of Medicare Severity-Diagnosis Related Group (MS-DRG)/DRG assignment. The PACM will submit monthly time records documenting time actually spent in the provision of the responsibilities outlined below.

Reporting Relationship
The PACM reports directly to the Chief Medical Officer of Mother Frances Hospital -Tyler with a dotted line to the Chief Financial Officer - Tyler

Professional Qualifications
The Physician Advisor-Care Management and Clinical Documentation Improvement role should be staffed by a physician with the following qualifications:

·Licensed physician in state of residence

·Certified by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP) - preferred

·Experienced in clinical practice with understanding of utilization review

·Served on or chaired a Utilization Management committee

·Demonstrated cost efficient practice

Physician Advisor - Care Management & CDI Duties and Responsibilities

Utilization Management Plan: 20%