Address
Form of workHybrid position, requiring some onsite days
Position Summary:
Maine Medical Center is seeking a Physician Advisor to join a dynamic, multidisciplinary team based in Portland, Maine. This position is based in Maine Medical Center's Department of Medical Affairs, and provides remote and on-site services to all nine hospitals across the MaineHealth system.
The Physician Advisor serves as a clinical consultant and liaison to care management, hospital administration, finance and the medical staff at large for matters related to correct patient status in the hospital, denial management, over and under-utilization of resources, medical necessity, compliance rules and regulations and relationships with payers and the community.
Maine Medical Center Physician Advisors benefit from a collegial working environment in a thriving academic medical center that truly values its employees. The Physician Advisor maintains strong working relationships with care managers, utilization review nurses, social workers, patient access coordinators, attending physicians, residents and fellows, nursing staff, staff in admitting and other health care professionals, working collaboratively to ensure quality patient care and effective, efficient utilization of health care services while meeting regulatory requirements.
Maine Medical Center has 637 licensed beds and is the state's leading tertiary care hospital and Level I Trauma Center, with a full complement of residencies and fellowships and an integral part of Tufts University Medical School. The successful candidate may have an academic appointment at Tufts University School of Medicine, and will have the opportunity to teach and mentor residents and medical students from the Maine Medical Center-Tufts University School of Medicine Medical School Program.
MaineHealth is a not-for-profit integrated health system whose vision is, "Working together so our communities are the healthiest in America." It consists of nine local health systems, a comprehensive behavioral health care network, diagnostic services, home health agencies, and 1,700 employed providers working together through the MaineHealth Medical Group. With approximately 22,000 employees, MaineHealth provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire.
Situated on the Maine coast, Portland offers the best of urban sophistication combined with small-town friendliness. The area provides four season recreational opportunities, such as skiing, hiking, sailing, and miles of beautiful beaches. Just two hours north of Boston, this is an exceptionally diverse and vibrant community.
Required Minimum Knowledge, Skills, and Abilities (KSAs):
Position Summary:
Maine Medical Center is seeking a Physician Advisor to join a dynamic, multidisciplinary team based in Portland, Maine. This position is based in Maine Medical Center's Department of Medical Affairs, and provides remote and on-site services to all nine hospitals across the MaineHealth system.
The Physician Advisor serves as a clinical consultant and liaison to care management, hospital administration, finance and the medical staff at large for matters related to correct patient status in the hospital, denial management, over and under-utilization of resources, medical necessity, compliance rules and regulations and relationships with payers and the community.
Maine Medical Center Physician Advisors benefit from a collegial working environment in a thriving academic medical center that truly values its employees. The Physician Advisor maintains strong working relationships with care managers, utilization review nurses, social workers, patient access coordinators, attending physicians, residents and fellows, nursing staff, staff in admitting and other health care professionals, working collaboratively to ensure quality patient care and effective, efficient utilization of health care services while meeting regulatory requirements.
Maine Medical Center has 637 licensed beds and is the state's leading tertiary care hospital and Level I Trauma Center, with a full complement of residencies and fellowships and an integral part of Tufts University Medical School. The successful candidate may have an academic appointment at Tufts University School of Medicine, and will have the opportunity to teach and mentor residents and medical students from the Maine Medical Center-Tufts University School of Medicine Medical School Program.
MaineHealth is a not-for-profit integrated health system whose vision is, "Working together so our communities are the healthiest in America." It consists of nine local health systems, a comprehensive behavioral health care network, diagnostic services, home health agencies, and 1,700 employed providers working together through the MaineHealth Medical Group. With approximately 22,000 employees, MaineHealth provides preventive care, diagnosis and treatment to 1.1 million residents in Maine and New Hampshire.
Situated on the Maine coast, Portland offers the best of urban sophistication combined with small-town friendliness. The area provides four season recreational opportunities, such as skiing, hiking, sailing, and miles of beautiful beaches. Just two hours north of Boston, this is an exceptionally diverse and vibrant community.
Required Minimum Knowledge, Skills, and Abilities (KSAs):
- Medical Degree (MD or DO) required; with a minimum of five years clinical practice experience; excellent clinical and communication kills and well respected by clinical colleagues.
- Eligibility for Maine State Medical License and Medical Staff privileges at Maine Medical Center (MMC) required.
- Experience as a Physician Advisor strongly preferred.
- Facility with Electronic Health Record, preferably Epic, and data analytic skills.
- Knowledge of utilization review methodologies including: proprietary criteria which guide appropriateness of care decision support, patient classification systems and insurance denial management; experience with federal and state audit programs.
- Knowledge of state regulations, Centers for Medicare & Medicaid Services (CMS) hospital conditions of participation and Joint Commission standards related to utilization review.
