Resident Advisor Jobs in Usa

About the Company

Masonicare Corporate Services - Wallingford, CT

About the Role

Assists residents with the Medicaid application process. Primary responsibility for Medicaid, Medicaid pending, Medicaid ineligible, and Self-Pay accounts. Performs daily banking procedures on resident/patient accounts and personal fund accounts.

Responsibilities

• Attend family meetings as necessary to assist with completion of financial paperwork and to discuss financial obligations; collecting required pre-payments.
• Reviews SNF admission applications to provide financial clearance.
• Medicaid Expeditor; responsible for facilitating completion of both new Medicaid applications and re-determinations for Medicaid.
• Monitors payer status for all pending and/or ineligible residents.
• Issues 30-day notices of noncompliance when residents do not meet financial or application requirements.
• Requests petition of conservatorship as necessary.
• Review AR accounts for legal and collection agency turnover.
• Serve as the liaison between Finance and our internal customers for patient and resident account issues.
• Work with Administrator, Finance and Billing Manager to review opportunities to improve/increase revenue or efficiency opportunities.
• Communicate effectively and tactfully with residents/patients recognizing their age, needs and abilities.
• Assure prompt resolution to questions or issues presented by resident/patients and other family members.
• Responsible for census management payer changes and accuracy.
• Oversight of Resident Trust for the facility.
• Perform additional duties as directed by the Manager, Healthcare Services Billing.

Qualifications

• Education: An equivalent combination of education and experience will be considered if related to the specified duties and responsibilities.
• Experience: Seven to ten years of experience directly related to skilled nursing healthcare revenue cycle activities.

Required Skills

• Experience in Medicaid application processes.
• Strong communication skills.
• Ability to work with diverse populations.

Preferred Skills

• Knowledge of skilled nursing healthcare revenue cycle activities.
• Experience with financial paperwork and obligations.

Pay range and compensation package

Day Shift / 40hrs/wk

Equal Opportunity Statement

Masonicare is committed to diversity and inclusivity in the workplace.

Join Tenet Healthcare as a Physician Advisor and Drive Meaningful Change (ON SITE)

Come to San Antonio, TX and take your career to the next level! Tenet Healthcare is seeking a board-certified physician to join our leadership team. This is an ON-SITE, full-time position. While experience as a PA is preferred, candidates with a strong desire to succeed will be considered. In this pivotal role, you’ll influence utilization management, documentation integrity, and physician education to improve patient care and hospital performance.

What You’ll Do

• Review cases for appropriate Level of Care and monitor observation stays
• Educate physicians and committees on utilization and documentation best practices
• Lead daily huddles, complex case conferences, and peer education
• Chair the Utilization Management Committee quarterly
• Manage payer denials, including peer-to-peer reviews
• Partner with CDI/HIM teams to improve documentation quality
• Partner with administration in reducing financial risks associated with denials as a result of unnecessary or preventable services and extended lengths of stay

What We’re Looking For

• Experience as a physician leader in a large system/hospital/integrated delivery system or leader of a large department
• MD or DO with current Texas license or ability to attain
• Board certified in specialty recognized by the American Board of Medical Specialties
• Reputation as an excellent clinician with a minimum of 5 years of experience in a hospital setting
• Strong communicator, respected among peers
• Data-driven mindset with measurable impact on outcomes
• Organized, collaborative, and effective with time management
• On-site, full-time presence

What We Offer

• Competitive compensation package including performance incentive
• Encouraged time off with coverage provided
• Generous benefit package including 401(k) match, CME, health, and PTO benefits
• Relocation assistance provided
• Ongoing training with access to personal performance metrics
• Cost coverage for National PA Prep Course & Certification Exam
• Connection to the best experts across Tenet’s expansive hospital network

About the Area

• No state income tax
• The city is projected to welcome 1.1 million new residents by 2040 and demographically represents what the US will look like in the future.
• Professional sports — San Antonio Spurs (NBA), San Antonio Missions baseball (MiLB), San Antonio FC soccer (USL), San Antonio Brahmas (XFL), and the annual Stock Show & Rodeo.

For immediate consideration, please submit CV.

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status.

• 
  Curriculum Vitae - Your most recently updated C.V.
  
• 
  Cover Letter (Optional)
  
• 
  Statement of Research - Statement of Research and Extension
  Please submit a 2-page Statement of Research and Extension Interests including how your current and/or past research and extension experience could contribute to, or be applicable to, the needs of the local community. Provide examples of potential goals and outcomes from your research and extension activities.
  
• 
  References - Please provide 3 references: names, titles and contact information.
  
• 
  College Level Transcripts - Electronic transcripts or legible scanned copies (PDF) of original transcripts will be accepted. Transcripts must identify course work completed, grades earned, degrees conferred and confer dates. Please DO NOT send transcripts that are password protected.
  

• 3-5 required (contact information only)

• Provide strategic leadership for resident care in the community by managing, directing, and monitoring the nursing team as applicable by State/Provincial law, to promote the health and wellness of the resident population.
• Provide clinical care through the direct application of the nursing process; perform and document resident assessments and progress notes, evaluate changes in care needs, complete Individualized Service Plans (ISP), provide or delegate hands-on clinical care as indicated by the plan of care, and evaluate resident outcomes.
• Collaborate with physicians, pharmacists, and other clinical providers to coordinate care and services for the residents.
• Serve as the CLIA Director as applicable for the community and according to the federal and provincial requirements.
• Partner with Neighborhood Coordinators to promote an integrated and collaborative approach to wellness operations and resident care.
• Collaborate with Sales partners to determine community capability and assess potential residents' appropriateness for move-in.

• Provide strategic leadership for resident care in the community by managing, directing, and monitoring the medication care managers, as applicable by State/Provincial law, to promote the health and wellness of the resident population.
• Provide oversight of the community medication management program to promote resident safety in the medication use process including onboarding, training, and performance reviews.
• Provide clinical training and education, as needed, to nurses, medication care managers, care managers, and others who provide resident care. Perform skill evaluation to assure clinical capability of care team members.

• Track, trend, and report clinical quality data to identify risk.
• Participate actively as a member of the community Quality Assurance and Performance Improvement committee.
• Lead clinical quality and process improvement initiatives within the community to mitigate risk and improve resident care outcomes.
• Recruit, hire, and train clinical team members and is responsible for performance management, evaluations, and engagement.
• Complete direct report team member staffing and scheduling according to operational and budgetary guidelines.
• Partner with the community leadership team to promote resident safety and compliance with Risk Management national/provincial regulations pertaining to occupational health and safety requirements.
• Serve as the ICC and CLIA Director as applicable for the community.
• Responsible for infection control programming, including delegation of infection control preventionist, as per provincial requirements.
• Assure compliance with all Federal, State/Provincial, board of nursing, and other applicable regulations.

• Manage the department budget to include labor/labour and other expenses and understand its impact on the community's bottom line.
• Processes and submit monthly expenses and budget data in a timely manner, per Sunrise policies and internal business controls.
• Understand the internal costs associated with all Sunrise resident care programs.

• Partner with the Regional Director of Resident Care and/or Executive Director in the delivery and participation in Sunrise University training and self-study programs.
• On-board new RCD leaders and other department coordinators as needed.
• Develop a working knowledge of state/provincial regulations and ensure compliance through supervising and coaching team members.
• Complete clinical team member staffing and scheduling according to operational and budgetary guidelines when assigned to a community.
• Hold clinical team accountable, correct actions when necessary, and document.
• Attend regular meetings; Stand Up, Cross Over, Department Head, Town Hall, QAPI, and others as directed by the Executive Director.
• Keep abreast of professional developments in the field by reading and attending conferences and training sessions.
• Maintain compliance in assigned required training and all training required by state/province or other regulating authorities as applicable to this role to ensure that Sunrise standards are always met.
• Perform other duties as assigned.

• Ability to delegate assignments to the appropriate individuals based on their demonstrated skill capability and in compliance with all regulations
• Proven ability to handle multiple priorities, organize efficiently, and manage time effectively
• Demonstrated critical thinking, clinical judgment, and decision-making skills

• Graduate of an accredited college or school of nursing
• Current state/provincial license as a professional Registered Nurse (RN)
• Minimum two (2) years RN experience with at least one (1) year experience in home health, assisted living, or long-term care environment preferred
• Minimum of one (1) year nursing management experience, including hiring, coaching, performance management, scheduling, and daily operations supervision
• Certified in CPR and First Aid
• Demonstrated knowledge of applied nursing practices, techniques, and methods in accordance with federal, state/provincial and board of nursing requirements.
• Knowledge of infection control practices and prevention of disease transmission
• Experience in tracking, trending, and analysis of clinical performance data preferred
• Experience in quality and clinical process improvement and risk assessment preferred
• Experience in staff development, training, and/or clinical education preferred
• Computer proficiency with electronic medical records, the Microsoft Office suite, and the ability to learn new applications
• Ability to work weekends, evenings and flexible hours as needed for resident care/services, including 24/7 on call responsibility

• Medical, Dental, Vision, Life, and Disability Plans
• Retirement Savings Plans
• Employee Assistant Program / Discount Program
• Paid time off (PTO), sick time, and holiday pay
• myFlexPay offered to get paid within hours of a shift
• Tuition Reimbursement
• In addition to base compensation, Sunrise may offer discretionary and/or non-discretionary bonuses. The eligibility to receive such a bonus will depend on the employee's position, plan/program offered by Sunrise at the time, and required performance pursuant to the plan/program.
• Some benefits have eligibility requirements

Private practice with no doors and no overhead.

BetterHelp is one of the world's largest online therapy platforms for mental health professionals who want to focus on client care — not admin or overhead. You provide the expertise. We handle the rest.

Why Join BetterHelp

• Competitive hourly compensation.
• $650 Health Benefit Stipend: Eligibility for the Health Benefit Stipend requires a continuous commitment of 30 hours a week
• No insurance headaches. No clawbacks. No payment delays. We handle everything — you get paid weekly for every session. Ai documentation.
• Increase Caseloads: 70% of clients use insurance, helping you build and sustain a strong caseload.
• $500 first client bonus* — Earn when you see your first insurance client within 30 days of applying.
• $2,000 first month bonus* - Providers licensed in NY, VA, MD, DC, can earn an additional $2k in their first month.

Additional Benefits

• Work from the comfort of home (fully remote)
• Flexible schedule – you set your own hours.
• Free access to 390+ CEU courses
• Free BetterHelp membership for self-care
• Insurance + cash-pay clients available
• Additional bonuses & incentives for high performers
• Zero overhead: No fees are collected from the therapist, ever.
• Autonomy over clinical decisions
• Access and connect with our community of over 30,000 therapists

We're Looking For

• LCSW, LPC, LMFT, LMHC, Licensed Professional Counselor, or Psychologist / PsyD
• Experienced Mental Health Therapist or Counselor with a passion for helping adults, couples, or teens.

Requirements:

• 3+ years of mental health counseling experience
• Master's or Doctorate in Counseling, Psychology, Social Work, or Marriage & Family Therapy
• Fully independent license (LCSW, LPC, LMFT, LMHC, etc.) and can provide therapy without supervision.
• U.S. residency, private workspace, reliable internet, and liability insurance
• A private and professional environment for conducting sessions.
• Excellent written communication.
• Must have professional liability insurance.
• Reliable Internet connection.
• Currently residing in the US.

NOTE: Unfortunately, if you are an intern or if you require supervision to provide therapy services, you cannot be a provider on BetterHelp at this time. Also, we are unable to accept substance abuse counselors, school counselors, registered nurses, career counselors, Christian counselors, and business coaches (unless they have an additional license as a mental health counselor). Experience counseling adults, couples, and/or teens.

*The use of the word "bonus" refers to an incentive provided to independent contractors. It does not imply an employment relationship nor entitle any independent contractors to employee benefits. Bonuses vary state to state and are subject to changes and certain requirements must be met to qualify for bonuses.

Counselor Social Worker & Clinical

Sign-on Bonus and Relocation Assistance available!

Receive 17% weekday nights, 26% weekend nights, or 15% weekend day shift differentials!

Now hiring for provisional, Non – Clinical and Clinical license!

*PRN Opportunities Available

*Part Time Opportunities Available

#1253 GRADUATE COUNSELOR SOCIAL WKR

Pay Rate: $22.49 - $33.74

LICENSES/CERTIFICATIONS:

Provisional license in Counseling or Social Work

#158 COUNSELOR SOCIAL WKR

Pay Rate: $26.22 - $39.33

LICENSES/CERTIFICATIONS:

LMSW or LPC or LMHC

#159 CLINICAL COUNSELOR SOCIAL WKR

Pay Rate: $28.32 - $42.48

LICENSES/CERTIFICATIONS:

One of the following:

Licensed Professional Clinical Counselor (LPCC) in State of New Mexico

Licensed Clinical Social Worker (LCSW) in State of New Mexico

Marriage and Family Therapist License State of New Mexico

PhD in a related discipline

Compensation Disclaimer

Compensation for this role is based on a number of factors, including but not limited to experience, education, and other business and organizational considerations.

Behavioral Health Clinical Services

The Behavioral Health Clinical Service line includes a number of Behavioral Health clinics across the hospital system. Your application may be considered for any of the below programs. We will work with you to find the best fit.

Provide, oversee, and/or administer a wide range of psychosocial evaluation/assessment, diagnostic, counseling therapy, crisis intervention, and/or case management services in a high-intensity clinical environment which requires a high degree of independent decision-making. Provide clinical training to provisional counselors/social workers, students, and/or interns engaged in related therapeutic/patient care activities, as appropriate to the individual position. Ensure adherence to Hospitals and departmental policies and procedures. Patient care assignment may include pediatric, adolescent, adult and geriatric age groups.

ASAP: Outpatient substance use treatment center. Services include individual/group therapy and walk-in counseling. Clinic works collaboratively with psychiatry, medication management, medication for opiate use disorders, primary care and case management. In addition, we offer an Intensive Outpatient Program for a higher level of care.

Behavior Response Team: Completes assessments and provides brief therapeutic support in the Emergency Departments and on the inpatient medical floors, and teleservices and in the community for the Mobile Response Team. This team works with all ages. This program currently operates 7 days a week with evening hours M-F this role is a 4/10s schedule with one weekend day.

Crisis Triage Center: Intended to assist adults in our community with stabilization and to engage in support services so they can effectively transition to outpatient care and to prevent inpatient hospitalizations. Therapists are expected to complete intake assessments, safety planning, individual sessions, and to facilitate one group a day. This role is a 4-10s schedule with one weekend day.

Integrated Behavioral Health: This is an integrated care service delivery model to address problems identified during primary or specialty care visits that are negatively affecting the patient's medical concerns or psychological functioning. They will also provide consultation to colleagues about the role of mental health and illness in how to understand a patient's functioning in the medical environment.

Metropolitan Detention Center: MDC PSU Counselors, take crisis calls throughout the jail. Assess for all inmates needing mental health services upon arrival to the jail, provide clearances on housing units, assess for Suicidal Ideation. In addition, these clinicians provide individual therapy, run meetings with security weekly, and may do integrated care for those receiving methadone/Suboxone.

Additional $6.00/hr. Safety Incentive Increase Cell phone and/or smart devices are not allowed on persons for this position at MDC, unless there is a documented medical condition.

Licensure/Certification Requirements - CPR Certification for Healthcare/BLS Providers or for Professional Rescuers or must obtain within 30 calendar days of date of position - Valid New Mexico Driver's License - Must obtain UNM Vehicle Operator's Permit w/i 60 days of position

-MDC Clearance

Multi-Systematic Therapy: Is an intensive community-based family service that provides family therapy in the home and incorporates all systems that affect the family including, but not exclusive to, school, legal and family's identified formal and non-formal support system. This clinic serves patients 12-17 years old to promote pro-social behaviors and reduce the risk of out of home placement.

Outpatient Psychotherapy Clinic: This outpatient clinic serves the adult and senior populations. We provide short-term evidence-based therapy through scheduled sessions and same-day walk-in appointments in an exciting and fast paced environment. We are looking for clinicians who thrive in a supportive, team-based environment and are passionate about providing accessible, high-quality care.

Pediatric and Adult Inpatient Units: Acute level of care in an inpatient unit for either children or adults due to danger to self, danger to others or due to grave disability. Treatment focus is on stabilization of symptoms, brief treatment modalities, medication interventions and discharge planning. This position works closely and collaboratively with a multidisciplinary team in a milieu setting.

Programs for Children and Adolescents: This is an outpatient therapy clinic that provides therapy for ages 5-18. We are a generalist clinic that treats a wide range of mental health presentations. We offer group therapy services and partner with psychiatry. We offer training opportunities in a range of treatment modalities and offer weekly consultation to support treatment and staff wellness.

Young Adult Clinic: This clinic offers services for at risk youth ages 15-26. The YAC team utilizes psychotherapy, case management, peer support and psychiatry to empower and assist youth in overcoming mental health struggles by fostering independence in many aspects of life including school, employment, housing, financial independence, medical care, and socialization.

Department: Behavioral and Mental Health

If you’re looking for a job that goes beyond the basics to deliver purpose and joy, you’ll find it here! Welcome to Leisure Care, where employees are here to inspire today’s older adults to embrace joy and purpose in their lives while doing the same in their own. For nearly 50 years, we’ve been reimagining and reinventing what it means to work in senior living, ensuring our employees have the most fulfilling and productive opportunities possible.

Our care-based services and superstar employees (like you!) inspire new and creative ways of serving our residents and their families. Our employees are the heart of Leisure Care communities, working together to provide exceptional care to support our residents so they can show up as their best selves every day.

With the best benefits in the biz, employees can build their dream job while knowing their work matters - and have a lot of fun doing it! But don’t just take our word for it. Our teams agree!  We’re a certified Great Place to Work and ranked among Fortune’s Best Workplaces in Aging Services!

We are now seeking a Resident Assistant to join our team!

This is a broad-scoped caregiver position. The Resident Assistant has full responsibility for direct resident care.

What you'll do:

• 
  
• Assist resident with all ADLs and personal care skills (bathing, dressing, grooming, toileting).
  
• Make appropriate observations about the resident’s condition in every interaction.
  
• Record and follow up with changes in resident’s condition in a timely manner.
  
• Assist residents with laundry and housekeeping services as needed.
  

What you'll bring:

• 
  
• Demonstrated experience in a caregiving role. 
  
• Current CNA or Home Health Aide preferred.
  

What we offer:

Our full-time benefits package is one of the best in the business. We offer it all:

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• Medical, Dental and Vision
  
• Early Wage Access (access to earned wages when needed!)
  
• 401k
  
• 10 days vacation & 1 hour Sick Leave earned for every 30 hours worked.
  
• Bereavement & Jury Duty Leave
  
• 6 Holidays
  
• 2 Float Holidays
  
• Flexible Spending Accounts (Health and Dependent Care)
  
• Meal Discounts
  
• Tuition Assistance
  
• Short Term Disability
  
• Term Life Insurance
  
• Term AD&D
  
• Critical Illness
  
• Hospital Indemnity
  

Apply today!

Leisure Care provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.  This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Join us as a Mental Health Counselor!

New Competitive Rates!

Days, Evenings - Adult, Adolescent, Child and Adult Units

As a Mental Health Counselor for TaraVista in Devens, Massachusetts, you'll bring your experience and knowledge where your voice matters. A Mental Health Counselor is an integral part of our multidisciplinary treatment team. You will provide direct care and support not only to our patients but also their families and make decisions that impact the lives of your peers, your patients, and your community. In exchange, we will care for you as much as you care for our patients. As a Mental Health Counselor,you will maintain a safe therapeutic milieu on inpatient behavioral health units. You will also conduct safety checks, monitor patients, assist with ADL's, de-escalate acute situations, and provide supportive interactions with patients.

As a Mental Health Counselor, you will:

• 
  
• Conduct patient observation and rounds.
  
• Assists staff with patient care while following treatment plans.
  
• Observe and monitor patient's progress and reports observations to staff.
  
• Develop a therapeutic relationship with patients while maintaining professional boundaries.
  
• Assist patients with activities of daily living skills, as necessary.
  
• Provide appropriate supervision of patients' activities.
  
• Responsible for safety monitoring of patients of the unit.
  
• Process admissions belongings.
  
• Complete documentation in the EMR system.
  
• Facilitate patient groups.
  
• Work collaboratively with the Interdisciplinary Team
  

Mental Health Counselor candidates will have the following:

• 
  
• High School Diploma. Bachelor's degree in psychology or human services field preferred.
  
• Previous PCT/PCA, CNA or Medical Assistant experience required.
  
• Bachelor's degree may be considered in lieu of experience.
  
• Effective oral and written communication skills; ability to develop a therapeutic relationship while maintaining professional boundaries.
  
• Previous experience in psychiatric or substance inpatient, restraint reduction de-escalation, and crisis intervention is preferred.
  

When you join the growing TaraVista team, you're not just taking a job, you're making a difference in people's lives.As our team member, you'll receive:

• 
  
• Medical, Dental, and Vision
  
• 401(k) match
  
• Employer paid short term disability (STD)
  
• Employer paid life and ADD Insurance
  
• Generous Paid Time Off
  
• Flexible Spending Account
  
• Tuition Reimbursement
  

Pay Range

Compensation will be determined based on the candidate's relevant experience.

$20.11-$24.00

TaraVista is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Job Description Do you want meaningful work you can feel proud of? Do you find joy in caring for others? Join Bishop Spencer Place , Kansas City's premier non-profit Life Care retirement community.

We areseeking a compassionate and dedicated Licensed Practical Nurse (LPN) to join our Skilled Nursing Facility.

Position Details : Licensed Practical Nurse (LPN)
- Skilled Nursing Unit Schedule: PRN ; Days Supportive environment where residents and staff are valued.

Our LPN's provide direct nursing care to residents and supervise the day-to-day nursing activities performed by CNA's.

Specific duties include: Meeting with assigned nursing personnel to plan the shifts' services, programs, and activities.

Overseeing the activity of assigned nursing assistants Administration of professional nursing services and medication to residents.

Ensuring residents receive services in accordance with their care plan Assisting with new admissions and discharges Consulting with residents, family members, and physicians in planning the resident's care, treatment, and rehabilitation Medication administration Visiting residents to observe and evaluate their physical and emotional status.

Notifying the resident's attending physician and next-of-kin when there is a change in the resident's condition Reporting problem areas to the RN Supervisor or Clinical Director Provides professional nursing care for clinic patients following established standards and practices.

Responsible for screening walk-in patients, telephone screening (with protocols), medication/injection education, assist with procedures, cleaning wounds, dressing changes, suctioning, catheter insertion, tracheostomy care, biopsies, diabetic nail care, and other duties as assigned by respective clinic .

Able to work in a team atmosphere, as well as, autonomously.

Excellent customer service skills and professional demeanor at all times.

Delegates tasks to unlicensed assistive personnel UAP in accordance with demonstrated competencies and consideration to Scope of Practice.

May be responsible for covering Medical Assistant job duties as needed Job Requirements Applicable Experience: Less than 1 year IV Certification
- National Council of State Boards of Nursing (NURSYS), Licensed Practical Nurse (KS)
- National Council of State Boards of Nursing (NURSYS), Licensed Practical Nurse (MO)
- National Council of State Boards of Nursing (NURSYS) Job Details PRN Day (United States of America) The best place to get care.

The best place to give care .

Saint Luke's 12,000 employees strive toward that vision every day.

Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City.

Joining Saint Luke's means joining a team of exceptional professionals who strive for excellence in patient care.

Do the best work of your career within a highly diverse and inclusive workspace where all voices matter.

Join the Kansas City region's premiere provider of health services.

Equal Opportunity Employer.

Position Details

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 910 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.

Work Hours per Biweekly Pay Period: 80.00

Shift:

Location: 1324 Lakeland Hills Blvd Lakeland, FL

Pay Rate: Min $161,200.00 Mid $215,300.80

Position Summary

The Physician Advisor serves as a liaison between the clinical document improvement (CDI) team, which includes hospital coders; members of the Hospital's administration; the Medical Staff of the hospital; and the hospital's Utilization Management to facilitate the development and implementation of clinical documentation improvement initiatives. The Physician Advisor is pivotal in leveraging his or her clinical position to demonstrate the association of care delivery with specificity in documentation. The Physician Advisor is responsible for conducting clinical reviews referred by the Utilization Management, Coding and Clinical Documentation Improvement departments. The Physician Advisor will assist with reviews and appeals of DRG and medical necessity denials.

Position Responsibilities

People At The Heart Of All We Do

• Fosters an inclusive and engaged environment through teamwork and collaboration.
• Ensures patients and families have the best possible experiences across the continuum of care.
• Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

Stewardship

• Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
• Knows and adheres to organizational and department policies and procedures.

Safety And Performance Improvement

• Behaves in a mindful manner focused on self, patient, visitor, and team safety.
• Demonstrates accountability and commitment to quality work.
• Participates actively in process improvement and adoption of standard work.

Supervisor/Team Lead Capabilities

• Demonstrates accountability for shift/team operations and care/service delivery to support achievement of organizational priorities.
• Coaches front line team members to support ongoing professional development and hardwire technical and professional capabilities.
• Creates a high performing team by building strong relationships, delegating work and nurturing commitment and engagement.
• Manages team conflict/issues implementing appropriate corrective actions, improvement plans and regular performance evaluations.
• Applies change management best practices and standard work to support departmental changes and ensure effective team transition.
• Promotes a healthy and safe culture to advance system, team and service experien

Standard Work: Physician Advisor

• Acts as a liaison between the CDI professionals, Health Information Management, and the hospital's medical staff to facilitate accurate and complete documentation for coding and abstracting of clinical data, capture of severity, acuity and risk of mortality, HCC/risk adjustment in addition to Diagnosis Related Group (DRG) assignment.
• Perform concurrent and retrospective reviews of selected health records as it pertains to CDI and coding validation, and participate in the development of clinically appropriate and compliant provider queries to further clarify documentation.
• Educates individual hospital staff physicians about International Classification of Diseases (ICD) coding guidelines and clinical terminology to improve their understanding of severity, acuity, risk of mortality, HCC/risk adjustment and DRG assignments on their individual patient records.
• Assists with the evaluation and appeal of concurrent and restrospective denials and retrospective DRG downgrades. May perform peer-to-peer meetings as required.
• Participates in the coding and CDI programs and identifies potential areas for improved documentation of services. Also participates in the Coding and CDI meetings and provides ongoing education to the team members.
• Provides peer to peer communication to affect the appropriate response for those cases where the physician fails to respond or questions the need for queries.
• Responsible for writing and submitting appeals (multiple levels as needed) specifically around medical necessity, non-covered services, authorizations, and inpatient/observation stay related denials. May perform peer-to-peer meetings as required.
• The Physician Advisor is pivotal in leveraging his or her clinical position to demonstrate the association of care delivery with specificity in documentation through effective communication and education of the respective parties.
• Provides his or her expert opinion in relation to clinical validity assessments, and, furthermore, the development of clinically robust and appropriate queries.
• Serves as second level reviewer for UM, providing guidance on appropriate/alternate levels of care based on InterQual guidelines and other appropriate criteria.

Competencies & Skills

Essential:

• Broad knowledge base of clinical medicine across all specialties.
• Basic coding guidelines regarding the selection of the principal diagnosis and reporting additional diagnoses and procedures; understanding the DRG system; levels of comorbidities; and concepts of risk adjustment, severity of illness, risk of mortality, case mix index, prospective payment, hospital acquired conditions, patient safety indicators.
• Organize tasks effectively and efficiently and the ability to act independently through the application of critical thinking skills.
• Computer skills appropriate to position
• Excellent written and verbal communication skills.

Qualifications & Experience

Essential:

• Medical Degree

Essential:

• Licensed to practice medicine in the state of Florida, shall be board certified in internal medicine, and shall meet any other reasonable professional criteria established by LRH or the hospital.

Other information:

Experience Essential:

- Minimum of two years of experience in conducting coding and CDI reviews.

- Knowledge of coding guidelines and how it translates from clinical documentation.

- Knowledge of DRGs, Risk of Mortality, Severity of Illness, Mortality Rate, HCC/risk adjustment, CMI and the impact of clinical documentation/coding in relation to these metrics.

- Excellent computer skills with prior exposure to use of Microsoft Office suite