Daytime Physician Advisor PRN

Reposted 18 Hours Ago
Be an Early Applicant
Crown Point, IN, USA
In-Office
Senior level
Healthtech
The Role
Provide clinical guidance and utilization review to case management and CDI teams. Advise physicians on level of care, length of stay, medical necessity, denials, and appeals. Conduct record reviews, peer-to-peer discussions, and collaborate with payers and hospital leadership to ensure compliance with CMS, state, and payer policies.
Summary Generated by Built In

Franciscan Health Crown Point

12750 S Francis Dr Crown Point, Indiana 46307

WHO WE ARE LOOKING FOR:

Franciscan Health Crown Point is seeking an experienced Board-Certified Internal Medicine physician to join our hospital as a Daytime PRN Physician Advisor.

WHAT WE NEED:

Ideal candidate must have 7+ years of experience as an internal medicine/sub-specialty physician. The Physician Advisor (PA) is expected to advise, educate and assist the local facility/facilities through teaching, consulting, and advising the Case Management (CM) Department, Clinical Documentation Improvement (CDI) 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. The PA will work collaboratively with the local leadership to address identified issues with practice patterns of specific providers.

WHAT YOU CAN EXPECT:

  • Promote Franciscan Crown Point compliance with CMS, State and Payer policy regarding inpatient admissions and observation status, as well as the appropriateness of continued hospital stay.
  • Work with Director of Clinical Effectiveness and Care Management to facilitate communication between payers and providers regarding benefit coverage issues, denials, utilization review and quality assurance processes.
  • Ensure Quality improvement activities comply with all relevant requirements by State /Federal/ Accreditation Body.
  • Conduct verbal and written review (including peer-to-peer) and appeal of denied or downgraded coverage determinations made by payers at local facility.
  • Provide feedback to treating physicians (attending and consultants) on appropriate level of care, length of stay, and quality issues. Also seek additional clinical information from the treating physicians (including appropriate documentation of the plan of care to resolve utilization issues or modification to the treatment plan) to ensure adherence to regulatory and compliance requirements.
  • Reviews medical records of patients referred by the care management team and assist with clinical review for level of care determination, length of stay management, denial management process and determine if MCG criteria or other professionally recognized standards of quality care are met.
  • Must portray excellent interpersonal and communication skills, with the ability to build consensus; noticeable skills in engaging physicians and finding synergies.
  • The ability to relate well to a wide variety of individuals.  Comfortable working in groups, forming teams of physicians and management, with an ease in working with other diverse groupings.

WHO WE ARE:

Franciscan Health is a non-profit health care system with primary and specialty care physician groups located throughout Indiana. Franciscan is known for our mission of caring. Our values of Respect for Life; Fidelity to Our Mission; Compassionate Concern; Joyful Service; and Christian Stewardship extend to our employees and patients.

With 12 hospitals, Franciscan Health is one of the largest Catholic health care organizations in the Midwest. Franciscan Health includes over 1,000 employed physicians and advanced practice providers. Franciscan providers enjoy a team approach to care. Of our 260+ locations, many are nationally recognized Centers of Health Care Excellence.

Indiana was recently ranked the #2 Best State to Practice Medicine, reflecting the supportive environment our physicians experience every day, including competitive compensation, a favorable malpractice climate, and an affordable cost of living. It’s an ideal place to build a rewarding, sustainable career while serving communities that truly value their caregivers.

WHAT WE OFFER:

At Franciscan Physician Network we strive to create a flexible and realistic work-life balance for our providers. Full- and part-time opportunities are offered with benefits, which could include:

  • Competitive compensation
  • Paid malpractice

MORE INFORMATION:

For more information, please contact Physician and Provider Services Team at [email protected] or (844) 376-3627.

WHERE WE LIVE:

Crown Point in Lake County, Indiana is a desirable community in which to live and work. Northwest Indiana has a reasonable cost of living, is family-friendly with award-winning schools.  Crown Point has a hometown atmosphere, with its historic downtown square, numerous unique shops, parks, golf courses, and other scenic locales.  Crown Point is in close proximity to Chicago, Lake Michigan beaches, area waterparks, and much more. Whether you are living on the lake or inland, Crown Point offers a little piece of paradise for each individual.  

Crown Point Attractions:

  • Lake County Fairgrounds hosts a large variety of festivals and entertainment throughout the year
  • Crown Point Farmer’s Market
  • Multiple golf courses
  • Lemon Lake County Park
  • Short- and Long-Term Own Occupation Disability
  • Customized marketing support
  • Leadership development through board and committee opportunities

MORE INFORMATION:

For more information, please contact Physician and Provider Services Team at [email protected] or (844) 376-3627.

TRAVEL IS REQUIRED:

Never or Rarely

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org

Skills Required

  • Board certification in Internal Medicine
  • 7+ years of experience as an internal medicine or sub-specialty physician
  • Experience with utilization review, medical necessity determination, and denial management
  • Familiarity with CMS, state and payer policies and MCG or other recognized standards
  • Experience working with Case Management and Clinical Documentation Improvement teams
  • Ability to perform verbal and written peer-to-peer reviews and appeals
  • Excellent interpersonal, communication, and consensus-building skills

Franciscan Health Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Franciscan Health and has not been reviewed or approved by Franciscan Health.

  • Healthcare Strength Benefits include medical, dental, and vision with broad network options, plus added savings when using system hospitals, labs, imaging, pharmacies, and physicians. Feedback suggests health coverage is solid, though not best-in-class.
  • Retirement Support An employer-funded retirement contribution is available alongside 403(b) and 457(b) options with defined eligibility and vesting. Feedback suggests this structure supports long-term savings across many roles.
  • Leave & Time Off Breadth PTO accrues with service and certain provider roles cite robust allotted time off and CME. Feedback suggests the presence of EAP and additional programs adds breadth to time-away support.

Franciscan Health Insights

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The Company
HQ: Mishawaka, IN
4,462 Employees
Year Founded: 1875

What We Do

The Franciscan Alliance healthcare ministry began in Lafayette, Ind., in 1875. Today, Franciscan Alliance is one of the largest Catholic health care systems in the Midwest with 12 hospital campuses in Indiana and Illinois, approximately 20,000 employees and a number of nationally recognized Centers of Health Care Excellence. Hospitals include: Franciscan Health Crown Point, Franciscan Health Michigan City, Franciscan Health Crawfordsville, Franciscan Health Lafayette East, Franciscan Health Indianapolis, Franciscan Health Carmel, Franciscan Health Rensselaer, Franciscan Health Mooresville, Franciscan Health Hammond, Franciscan Health Dyer, Franciscan Health Munster and Franciscan Beacon Hospital in Indiana; and Franciscan Health Olympia Fields in Illinois. For more information, visit FranciscanHealth.org. With more than 850 primary and specialty care providers at over 260 locations in Indiana and Illinois, Franciscan Physician Network is one of the largest and most respected multi-specialty physician networks in the Midwest providing convenient, comprehensive care

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