Detroit, MI, United States
Healthcare, Case Management
Jun 13, 2023
Department: Physician Advisor-Administration
Hospital: Ascension St. John Hospital
Location: Detroit, Michigan
Paid time off (PTO)Various health insurance options & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee assistance programs (EAP)Parental leave & adoption assistanceTuition reimbursementWays to give back to your community
As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.
*Please note, benefits and benefits eligibility can vary by position, exclusions may apply for some roles (for example: PRN, Short-Term Option, etc.). Connect with your Talent Advisor today for additional specifics.
Reporting to the Chief Medical Officer and works collaboratively with the Vice President of Case Management.
Works in collaboration with medical staff, case management and clinical documentation specialists (CDI) to ensure effective use of the hospital's resources toward the delivery of high value, efficient patient care.
Serves as a liaison and education resource for medical staff and clinical associates to address issues of level of care determination and improvements in clinical documentation to support patient discharge and transitions of care.
Acts as consultant to and resource for attending physicians regarding their decisions relative to appropriateness of hospitalization, continued stay, and appropriate use of resources to reduce avoidable days.
Responsible for the timely review of medical records of identified patients to assist with the level of care and length of stay determination
Serves as a liaison between case management/nursing staff and medical staff to eliminate barriers for discharge
Participates in daily floor rounds to identify areas of opportunity for timely transition of care
Serves as a Physician leader to facilitate patient movement during high census or bed crises
Provides feedback to attending and consulting physicians regarding level of care, length of stay, utilization of resources and quality issues
Collaborates with V.P of Case Management to manage the denial management process. Reviews and offers suggestions related to resources and service management
Provides education to physicians and other clinicians on regulatory requirements, appropriate utilization of alternate levels of care, community resources and end of life care
Develops strategy and processes to reduce denials and audits
Utilizes hospital data sources to identify & analyze patterns of over or under-utilization of services, quality metrics and makes recommendations towards achievement of those goals
Keeps abreast of regulatory, legal, reimbursement changes, and industry trends
Creative review and coordination of care delivery in complex cases
Licensure / Certification / Registration :
Board certified in specialty
Physician MD/DO with Prescriptive Authority credentialed from the Michigan Board of Medicine obtained prior to hire date or job transfer date. Verified by local Credentialing Office.
Doctor of Medicine (MD), Doctor of Osteopathy (DO), Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DMD), Doctor of Optometry (OD), or Doctor of Podiatric Medicine (DPM) required.
2-4 years Case Management/Utilization Review Experience
Why Join Our Team
About Ascension St. John Hospital
Ascension St. John Hospital was founded in 1952 and is a regional referral teaching hospital.
We provide comprehensive accredited training to over 200 resident physicians, 30 fellows, and 56 core medical students in accordance to ACGME requirements.
Level I Trauma Center with a Chest Pain Center and Heart Failure Center accreditation
Certified Stroke Center with advanced certification by the Joint Commission. We specialize in neuro-endovascular treatments for acute stroke.
Named a Blue Distinction Center in both cardiovascular and orthopedic care by Blue Cross Blue Shield of Michigan and Blue Care Network
Averaging 28,000 admissions, 3,000 births, 15,000 inpatient/outpatient surgeries and over 105,000 ER visits annually
Located in southeast Michigan near Lake St. Clair and the five Grosse Pointe communities; private parks, boutique shops, art galleries, coffee shops and restaurants
Home to Belle Isle Island and Aquarium, Detroit Institute of Arts, Detroit Opera House, Detroit Symphony Orchestra, Fisher Theatre, and four professional sports teams
Voted America’s Great Comeback City
About Ascension Medical GroupWhen you join Ascension Medical Group (AMG), you are entering a community where physician and advanced practice provider engagement and experience is recognized as a key driver of delivering excellent patient care. With 1,900 sites of care and 7,000 providers strong, AMG is one of the largest healthcare provider networks in the United States. Physicians and advanced practice providers benefit from a collaborative approach to care, significant professional opportunities, career advancement, training and competitive wages.
Equal Employment Opportunity Employer
Ascension will provide equal employment opportunities (EEO) to all associates and applicants for employment regardless of race, color, religion, national origin, citizenship, gender, sexual orientation, gender identification or expression, age, disability, marital status, amnesty, genetic information, carrier status or any other legally protected status or status as a covered veteran in accordance with applicable federal, state and local laws.
For further information, view the EEO Know Your Rights (English) (https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRights_10_20.pdf) poster or EEO Know Your Rights (Spanish) (https://www.eeoc.gov/sites/default/files/2022-10/22-088_EEOC_KnowYourRightsSp_10_20.pdf) poster.
Pay Non-Discrimination Notice (https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_ English_formattedESQA508c.pdf)
Please note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.E-Verify (https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf)
Website : http://www.athenahealth.com