Physician Advisor Salary in Cincinnati, OH

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is committed to providing an inclusive, equitable and diverse place of employment. The RN-Utilization Review nurse will use established criteria and policy/procedures to perform pre-admission, admission, and continued stay reviews on inpatient and observation cases in a timely manner. UR Nurse will work with hospital Care Management staff, Social Work, and Revenue Cycle team members, as well as with managed care agencies to assure certification of the patient's entire stay so that hospital receives maximum reimbursement.Minimum Required: RN with current license. Preferred: BSN | Current RN license in Ohio. | Minimum Required: 3 - 5 Years equivalent experience.Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today! About UC HealthUC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.Same Posting Description for Internal and External CandidatesProductivity: Maintains productivity at or above the defined standard for the specific area of UR. Reviews and evaluates assigned cases within one business day and as appropriate throughout the patient's stay. Accuracy: Reviews and evaluates physician orders at the time of admission or upon first review for the correct inpatient vs observation status as it relates to regulatory requirements (such as CMS 2 MN rule), established review criteria, and patient's clinical symptoms and findings. Enters all utilization review data into the appropriate fields/screens in the Epic system as outlined in policies/procedures. Maintains accuracy at or above the defined standard for the department. Communication: Works with physicians, as needed, to ensure that documentation supports level of care criteria and medical necessity. Escalates as appropriate to physician advisor or Utilization Review leadership. Communicates findings to managed care companies and other members of the revenue cycle team to assure certification of days for reimbursement. Assists in peer-to-peer denial/appeal process while patient is still in the hospital, aggressively advocating on the patient and hospital's behalf. Collaborates with the Care Management/Social Work team on payer issues related to admission or continued stay to resolve identified issues and to facilitate discharge planning. Job Knowledge: Maintains current knowledge and is capable of applying InterQual or MCG criteria in the review process. Serves as a consistent resource regarding utilization review issues. Participates in educating members of the patient care team relative to managed care and/or regulatory guidelines for utilization review. Demonstrates ability to creatively and independently problem solve, intervene at appropriate levels, and evaluate outcomes of intervention on a consistent basis. Keeps abreast of current rules, regulations, policies and procedures related to third party payers, CMS, Joint Commission and other regulatory agencies. Quality/Performance Improvement: Participates in data collection and analysis, as required, related to utilization activities such as (but not limited to) avoidable days, LOS, readmissions. Supports performance improvement initiatives and participates in identification of opportunities for improvement. Professional Development: Attends appropriate clinical and professional organizations, workshops and meetings as required. Completes all required internal education. Remains current on clinical advancements related to specific patient populations and changes to established criteria sets. Proactively seeks to understand areas/roles outside of immediate role.Productivity: Maintains productivity at or above the defined standard for the specific area of UR. Reviews and evaluates assigned cases within one business day and as appropriate throughout the patient's stay. Accuracy: Reviews and evaluates physician orders at the time of admission or upon first review for the correct inpatient vs observation status as it relates to regulatory requirements (such as CMS 2 MN rule), established review criteria, and patient's clinical symptoms and findings. Enters all utilization review data into the appropriate fields/screens in the Epic system as outlined in policies/procedures. Maintains accuracy at or above the defined standard for the department. Communication: Works with physicians, as needed, to ensure that documentation supports level of care criteria and medical necessity. Escalates as appropriate to physician advisor or Utilization Review leadership. Communicates findings to managed care companies and other members of the revenue cycle team to assure certification of days for reimbursement. Assists in peer-to-peer denial/appeal process while patient is still in the hospital, aggressively advocating on the patient and hospital's behalf. Collaborates with the Care Management/Social Work team on payer issues related to admission or continued stay to resolve identified issues and to facilitate discharge planning. Job Knowledge: Maintains current knowledge and is capable of applying InterQual or MCG criteria in the review process. Serves as a consistent resource regarding utilization review issues. Participates in educating members of the patient care team relative to managed care and/or regulatory guidelines for utilization review. Demonstrates ability to creatively and independently problem solve, intervene at appropriate levels, and evaluate outcomes of intervention on a consistent basis. Keeps abreast of current rules, regulations, policies and procedures related to third party payers, CMS, Joint Commission and other regulatory agencies. Quality/Performance Improvement: Participates in data collection and analysis, as required, related to utilization activities such as (but not limited to) avoidable days, LOS, readmissions. Supports performance improvement initiatives and participates in identification of opportunities for improvement. Professional Development: Attends appropriate clinical and professional organizations, workshops and meetings as required. Completes all required internal education. Remains current on clinical advancements related to specific patient populations and changes to established criteria sets. Proactively seeks to understand areas/roles outside of immediate role.

Location: UC Health LLC: Remote Hours: Full time Shift: First The UR Supervisor, functioning as a professional registered nurse, is responsible and accountable for directing and insuring quality nursing care, effective utilization of resources, and maintaining sound organizational relationships as delegated by the System Director of Revenue Cycle. The Supervisor is competent in all areas of the Denial/Charge Audit Department. The Supervisor collaborates with the System Director of Revenue Cycle to plan, organize and evaluate department processes to assure cost effective delivery of care.Minimum Required: Bachelors Degree, Nursing Minimum Required: 3 - 5 Years equivalent experience. Preferred: 6 - 10 Years equivalent experience. Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today! About UC Health UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.Job Function: Department Operations Demonstrates competency to function in Denials Management nurse role. Review denial cases and provide feedback to staff. Will be required to have full Denial/Charge Audit nurse assignment, as needed determined by staffing need. Performs other duties as assigned. Acts as resource for staff. Assists with Physician Advisor Program and vendor case submission to review. Job Function: Leadership & Administrative Duties Assists Director with developing, implementing and evaluating unit goals. Assists with the identification and implementation of annual performance improvement projects. Assures staff compliance with hospital policies, departmental goals, performance improvement initiatives, and regulatory agency requirements. Assists with unit's achievement of defined goals for patient satisfaction. Assists Director with appropriate response/action plans for staff who do not meet minimum expectations. Assists with monthly unit meetings. Effectively manages time. Assists with problem solving and conflict resolution. Job Function: Resource Management Assists with unit payroll. Participates in the recruitment, selection, and retention of qualified personnel. Assists with maintaining staff satisfaction. Assists with staff scheduling and staffing. Assignments reflect appropriate utilization of personnel. Job Function: Professional Development Maintain current knowledge and skills related to Denials/Charge Audit criteria Job Function: Department Operations Demonstrates competency to function in Denials Management nurse role. Review denial cases and provide feedback to staff. Will be required to have full Denial/Charge Audit nurse assignment, as needed determined by staffing need. Performs other duties as assigned. Acts as resource for staff. Assists with Physician Advisor Program and vendor case submission to review. Job Function: Leadership & Administrative Duties Assists Director with developing, implementing and evaluating unit goals. Assists with the identification and implementation of annual performance improvement projects. Assures staff compliance with hospital policies, departmental goals, performance improvement initiatives, and regulatory agency requirements. Assists with unit's achievement of defined goals for patient satisfaction. Assists Director with appropriate response/action plans for staff who do not meet minimum expectations. Assists with monthly unit meetings. Effectively manages time. Assists with problem solving and conflict resolution. Job Function: Resource Management Assists with unit payroll. Participates in the recruitment, selection, and retention of qualified personnel. Assists with maintaining staff satisfaction. Assists with staff scheduling and staffing. Assignments reflect appropriate utilization of personnel. Job Function: Professional Development Maintain current knowledge and skills related to Denials/Charge Audit criteria

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is committed to providing an inclusive, equitable and diverse place of employment. The RN-Utilization Review nurse will use established criteria and policy/procedures to perform pre-admission, admission, and continued stay reviews on inpatient and observation cases in a timely manner. UR Nurse will work with hospital Care Management staff, Social Work, and Revenue Cycle team members, as well as with managed care agencies to assure certification of the patient's entire stay so that hospital receives maximum reimbursement.Minimum Required: RN with current license. Preferred: BSN | Current RN license in Ohio. | Minimum Required: 3 - 5 Years equivalent experience.Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today! About UC HealthUC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.Same Posting Description for Internal and External CandidatesProductivity: Maintains productivity at or above the defined standard for the specific area of UR. Reviews and evaluates assigned cases within one business day and as appropriate throughout the patient's stay. Accuracy: Reviews and evaluates physician orders at the time of admission or upon first review for the correct inpatient vs observation status as it relates to regulatory requirements (such as CMS 2 MN rule), established review criteria, and patient's clinical symptoms and findings. Enters all utilization review data into the appropriate fields/screens in the Epic system as outlined in policies/procedures. Maintains accuracy at or above the defined standard for the department. Communication: Works with physicians, as needed, to ensure that documentation supports level of care criteria and medical necessity. Escalates as appropriate to physician advisor or Utilization Review leadership. Communicates findings to managed care companies and other members of the revenue cycle team to assure certification of days for reimbursement. Assists in peer-to-peer denial/appeal process while patient is still in the hospital, aggressively advocating on the patient and hospital's behalf. Collaborates with the Care Management/Social Work team on payer issues related to admission or continued stay to resolve identified issues and to facilitate discharge planning. Job Knowledge: Maintains current knowledge and is capable of applying InterQual or MCG criteria in the review process. Serves as a consistent resource regarding utilization review issues. Participates in educating members of the patient care team relative to managed care and/or regulatory guidelines for utilization review. Demonstrates ability to creatively and independently problem solve, intervene at appropriate levels, and evaluate outcomes of intervention on a consistent basis. Keeps abreast of current rules, regulations, policies and procedures related to third party payers, CMS, Joint Commission and other regulatory agencies. Quality/Performance Improvement: Participates in data collection and analysis, as required, related to utilization activities such as (but not limited to) avoidable days, LOS, readmissions. Supports performance improvement initiatives and participates in identification of opportunities for improvement. Professional Development: Attends appropriate clinical and professional organizations, workshops and meetings as required. Completes all required internal education. Remains current on clinical advancements related to specific patient populations and changes to established criteria sets. Proactively seeks to understand areas/roles outside of immediate role.Productivity: Maintains productivity at or above the defined standard for the specific area of UR. Reviews and evaluates assigned cases within one business day and as appropriate throughout the patient's stay. Accuracy: Reviews and evaluates physician orders at the time of admission or upon first review for the correct inpatient vs observation status as it relates to regulatory requirements (such as CMS 2 MN rule), established review criteria, and patient's clinical symptoms and findings. Enters all utilization review data into the appropriate fields/screens in the Epic system as outlined in policies/procedures. Maintains accuracy at or above the defined standard for the department. Communication: Works with physicians, as needed, to ensure that documentation supports level of care criteria and medical necessity. Escalates as appropriate to physician advisor or Utilization Review leadership. Communicates findings to managed care companies and other members of the revenue cycle team to assure certification of days for reimbursement. Assists in peer-to-peer denial/appeal process while patient is still in the hospital, aggressively advocating on the patient and hospital's behalf. Collaborates with the Care Management/Social Work team on payer issues related to admission or continued stay to resolve identified issues and to facilitate discharge planning. Job Knowledge: Maintains current knowledge and is capable of applying InterQual or MCG criteria in the review process. Serves as a consistent resource regarding utilization review issues. Participates in educating members of the patient care team relative to managed care and/or regulatory guidelines for utilization review. Demonstrates ability to creatively and independently problem solve, intervene at appropriate levels, and evaluate outcomes of intervention on a consistent basis. Keeps abreast of current rules, regulations, policies and procedures related to third party payers, CMS, Joint Commission and other regulatory agencies. Quality/Performance Improvement: Participates in data collection and analysis, as required, related to utilization activities such as (but not limited to) avoidable days, LOS, readmissions. Supports performance improvement initiatives and participates in identification of opportunities for improvement. Professional Development: Attends appropriate clinical and professional organizations, workshops and meetings as required. Completes all required internal education. Remains current on clinical advancements related to specific patient populations and changes to established criteria sets. Proactively seeks to understand areas/roles outside of immediate role.

Customer Service Consultant , First Shift, Patient Relations UC Health is hiring a full-time Customer Service Consultant for the Patient Relations department for the first shift at University of Cincinnati Medical Center. The Customer Service Consultant will support the Medical Centers and deliver high-quality care to patients based on assessed needs, established standards of care and according to policy and procedures. About University of Cincinnati Medical Center As part of the Clifton Campus of UC Health, Greater Cincinnati's academic health system, University of Cincinnati Medical Center has served Greater Cincinnati and Northern Kentucky for nearly 200 years. Each year, hundreds of thousands of patients receive care from our world-renowned clinicians and care team. Our experts utilize the most advanced medical knowledge and technology available, providing a level of specialty and subspecialty medical care that is not available anywhere else in Greater Cincinnati. UC Medical Center is also home to medical breakthroughs- our physician experts conduct basic, translational and clinical research, leading to new therapies and care protocols, and connecting patients to the latest and most advanced treatments. UC Medical Center houses Greater Cincinnati's only Level I adult trauma center, which includes the right mix of specialist and medical resources available at a moment's notice for a wide variety of the most complex medical conditions and injuries.Education and Experience Requirements: Associate's Degree required. Notary Public for the State of Ohio preferred. Three years' experience in complaint management, conflict resolution and customer service in a healthcare environment. Demonstrated ability to work with a diverse population. Training and public presentation skills Must have strong customer service and communication skills both written and verbal. Skilled in sensitivity awareness Able to apply insight and sound judgment in stressful situations. Able to assess and resolve operational and system problems. Must demonstrate ability to utilize Microsoft Office products. Bilingual communication skills are preferred. Experience with Microsoft various programs (MIDAS and LastWord is preferred) At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering. As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is committed to providing an inclusive, equitable, and diverse place of employment.Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!About UC Health UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, Daniel Drake Center for Post-Acute Care, Bridgeway Pointe Assisted Living, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.Job Responsibilities The primary function of the Customer Service Consultant is to work in partnership with the healthcare team to enhance overall customer satisfaction for patients, visitors and staff through excellent service and quality care. This includes supporting a proactive vs. reactive approach to resolving problems and complaints with respect to care, treatment, patient rights and ability to access hospital services. Proactive consultation to managers and staff with the goal of improving patient and family experiences. Competent to discuss the state of patient experience, complaint volumes with all levels of management. Serves as an expert in patient satisfaction; able offer recommendations to increase patient satisfaction. Educating staff on queues to help identify potential issues that may result in a complaint or grievance, customer service best practices and service recovery methods. Attend and participate in unit/department staff meetings as requested. Communicate information about the hospital's policies and procedures, informing patients, families, and visitors of hospital services available to them, i.e. parking, helping to arrange overnight stays, etc. Listen empathetically to patient concerns and communicate special needs of patient /family/visitor with staff and administration when appropriate. Advocate for quality care, treatment, respect and rights of all patients. Mediation in family meetings with treatment team and families. Maintain notary license if requested at the UC site you work at and provide notary services for patients, families and staff as requested. Make suggestions and recommendations to improve customer service processes throughout the system. Provide equipment for hearing impaired, i.e. TTY volume control phones, light signalers, call lights, tele sitters, etc. Provide service recovery as appropriate based on sub-par service received. Work in partnership with the unit/department leaders and staff to address issues or complaints through early intervention and problem resolution. Assess situations of risk and refer issues of malpractice, personal injury, wrongful death, abuse, and missing personal property to Risk Management. Evaluate situations requiring substitute consent, when patients have no next of kin and are physically and/or mentally unable to give informed consent and refer staff to call Ethics consult team. Refer immediate patient and family concerns and/or compliments to appropriate department leaders in a timely manner. Proficiency uses emotional intelligence to manage both your own emotions and understand the emotions of patients, family, and staff around you. Situational awareness to perceive, understand and effectively respond to one's situation. Critical thinking and problem-solving skills to aid in complaint resolution and education. Make referrals to appropriate departments/services for patient assistance when appropriate. Follow-up with those patients who have identified a concern during their hospital visit. Provide professional etiquette and empathetic service on both phone and in person meetings. Professional de-escalation techniques both on the phone and in person with upset patients and family. Active listening to build rapport and improve mutual understanding. Use of appropriate questioning based on each situation to gain understanding about the concerns. Written documentation will be timely, accurate, professional, complete and grammatically correct. Case documentation will communicate to anyone reading the case the details of what, who, why, how as well as the outcome of the investigation into the case. Follow up with patient or family will be documented in the case documentation. Track problem areas and identify trends happening in specific departments/units. Identify system problems; make recommendations; and assist in resolutions and opportunities for improvement in service delivery. Participate in the development of policies and procedures related to patient rights and satisfaction. Provide timely, accurate and complete documentation regarding the investigation process, i.e. subjective data; objective data; assessment; and resolution as well as documented follow up to the complainant. Attend departmental staff meetings and mandatory in-service training sessions. Job Responsibilities The primary function of the Customer Service Consultant is to work in partnership with the healthcare team to enhance overall customer satisfaction for patients, visitors and staff through excellent service and quality care. This includes supporting a proactive vs. reactive approach to resolving problems and complaints with respect to care, treatment, patient rights and ability to access hospital services. Proactive consultation to managers and staff with the goal of improving patient and family experiences. Competent to discuss the state of patient experience, complaint volumes with all levels of management. Serves as an expert in patient satisfaction; able offer recommendations to increase patient satisfaction. Educating staff on queues to help identify potential issues that may result in a complaint or grievance, customer service best practices and service recovery methods. Attend and participate in unit/department staff meetings as requested. Communicate information about the hospital's policies and procedures, informing patients, families, and visitors of hospital services available to them, i.e. parking, helping to arrange overnight stays, etc. Listen empathetically to patient concerns and communicate special needs of patient /family/visitor with staff and administration when appropriate. Advocate for quality care, treatment, respect and rights of all patients. Mediation in family meetings with treatment team and families. Maintain notary license if requested at the UC site you work at and provide notary services for patients, families and staff as requested. Make suggestions and recommendations to improve customer service processes throughout the system. Provide equipment for hearing impaired, i.e. TTY volume control phones, light signalers, call lights, tele sitters, etc. Provide service recovery as appropriate based on sub-par service received. Work in partnership with the unit/department leaders and staff to address issues or complaints through early intervention and problem resolution. Assess situations of risk and refer issues of malpractice, personal injury, wrongful death, abuse, and missing personal property to Risk Management. Evaluate situations requiring substitute consent, when patients have no next of kin and are physically and/or mentally unable to give informed consent and refer staff to call Ethics consult team. Refer immediate patient and family concerns and/or compliments to appropriate department leaders in a timely manner. Proficiency uses emotional intelligence to manage both your own emotions and understand the emotions of patients, family, and staff around you. Situational awareness to perceive, understand and effectively respond to one's situation. Critical thinking and problem-solving skills to aid in complaint resolution and education. Make referrals to appropriate departments/services for patient assistance when appropriate. Follow-up with those patients who have identified a concern during their hospital visit. Provide professional etiquette and empathetic service on both phone and in person meetings. Professional de-escalation techniques both on the phone and in person with upset patients and family. Active listening to build rapport and improve mutual understanding. Use of appropriate questioning based on each situation to gain understanding about the concerns. Written documentation will be timely, accurate, professional, complete and grammatically correct. Case documentation will communicate to anyone reading the case the details of what, who, why, how as well as the outcome of the investigation into the case. Follow up with patient or family will be documented in the case documentation. Track problem areas and identify trends happening in specific departments/units. Identify system problems; make recommendations; and assist in resolutions and opportunities for improvement in service delivery. Participate in the development of policies and procedures related to patient rights and satisfaction. Provide timely, accurate and complete documentation regarding the investigation process, i.e. subjective data; objective data; assessment; and resolution as well as documented follow up to the complainant. Attend departmental staff meetings and mandatory in-service training sessions.