Sarasota Memorial located in Florida is seeking a

Physician Advisor Integrated Case Management

 

Sarasota Memorial Health Care System, an 829-bed regional medical center, is among the largest acute care public health systems in Florida. With more than 5,000 staff and 500 volunteers, it is one of Sarasota County’s largest employers. A community hospital founded in 1925, Sarasota Memorial is governed by a nine-member elected Sarasota County Public Hospital Board. We are a full-service health system, with specialized expertise in heart, vascular, cancer, and neuroscience services, as well as a network of outpatient centers, long-term care and rehabilitation among its many programs. Sarasota Memorial is the only provider of Level II trauma services, obstetrical services and Level III neonatal intensive care in Sarasota County.

Job Summary

This dynamic full-time Physician Advisor provides 1) physician administrative support and leadership to the utilization and resource management areas of Integrated Case Management including mentoring/coaching Care Coordinators, Utilization Review staff, and Social Workers, 2) reviewing cases for medical necessity, 3) daily multi-disciplinary rounds, 4) collaborating with hospitalists, physicians, and house staff in determining appropriate inpatient versus outpatient/observation status, and providing feed-back on documentation improvement opportunities 5) participating in third-party payor denial, appeal, and peer-to-peer processes. 

Identifying and benchmarking standards of best practice related to throughput, efficiency, length of stay, resource utilization, high quality admissions, readmission avoidance, and transitions of care across the continuum is an organizational standard.  The physician advisor will consider compliance with regulatory and payor requirements, policy and organizational goals, and quality patient outcomes when performing patient reviews.  This position will be an active member of the Utilization Review Committee.

 

Required Qualifications

MD or DO from an accredited school of medicine

Board Certification

Active Florida medical license

Qualified as a provider under Medicare and Medicaid

Current medical staff privileges or the ability to be credentialed for staff privileges at any Sarasota Memorial Health Care System hospital

A minimum of three (3) years of hospital acute care experience with exposure to utilization management and documentation initiatives

A minimum of one (1) year of leadership experience

Experience in case management, care coordination, and utilization management

Maintains current knowledge of federal, state, and payor regulatory and contract requirements

Demonstrated teamwork, performance analysis, presentation, facilitation, planning, and communication skills.

Ability to maintain positive rapport with hospital and departmental leadership, case management staff, and physicians

Preferred Qualifications

Internal Medicine or Family Medicine

Previous experience as a physician advisor

Experience in managed care contracting and familiarity with Medicare and managed care reimbursement policies

Preferred License and Certifications

ABQAURP (American Board of Quality Assurance and Utilization Review Physicians), with a physician advisor sub-specialty

 

Physician Advisor:  Salary is 300,000 to 350,000 per year, plus bonus

Please visit the website at Sarasota or contact below for more information:

Diane Settle (VP, Revenue Cycle)

941-917-1479

diane-settle@smh.com

www.smh.com

Sarasota Memorial located in Florida is seeking a

Manager, Integrated Case Management

This is a full time position:

 

Sarasota Memorial Health Care System, an 829-bed regional medical center, is among the largest acute care public health systems in Florida. With more than 5,000 staff and 500 volunteers, it is one of Sarasota County’s largest employers. A community hospital founded in 1925, Sarasota Memorial is governed by a nine-member elected Sarasota County Public Hospital Board. We are a full-service health system, with specialized expertise in heart, vascular, cancer, and neuroscience services, as well as a network of outpatient centers, long-term care and rehabilitation among its many programs. Sarasota Memorial is the only provider of Level II trauma services, obstetrical services and Level III neonatal intensive care in Sarasota County.

This leader has operational accountability and oversight and manages the daily activities of the department or responsible area and supports best practice standards for department functions and the Case Management Program. In this role, the manager sets the tone and models positive leadership behavior, while ensuring that teamwork tasks, projects, and responsibilities are completed successfully in support of departmental and organizational goals. The Manager adheres to all Federal, State and regulatory statues and accreditation requirements. The Manager supports the Director in developing, planning and implementing appropriate changes in keeping with case management best practice standards and organizational goals.

Required Qualifications:

Require graduate of an accredited school of Nursing or Social Work.

Registered Nurse:

Require Bachelor of Science in Nursing (BSN) degree; Master of Science in Nursing (MSN) degree is preferred.

 

Social Worker: Require a Master of Science in Social Work (MSW) degree.

Licensure Requirement: For Registered Nurse: Require active State of Florida Registered Nurse licensure.

For Social Worker:

Require active State of Florida Licensed Clinical Social Worker (LCSW) or Licensed Mental Health Counselor (LMHC).

Certification Requirement: Require certification in Case Management (CCM or ACMA certification) or must be obtained within one (1) year from hire/transfer date. (If LCSW, certification may be waived.)  ACM-SW, A-SWCM or CCM is required.

Salary:  100,000-130,000 per year plus bonus

Please visit the website at Sarasota or contact below for more information

Applicants Should Contact:

J.R. Edmiston, Director of Revenue Cycle

941-917-1421

James-edmiston@smh.com

www.smh.com