Holy Cross Health

Holy Cross Health is seeking a full-time Physician Advisor located in Silver Spring, Maryland.

The Physician Advisor provides expertise related to appropriate utilization/level of care (LOC), length of stay (LOS) management, patient flow/throughput management, appropriate clinical documentation, and CDI. Engages physicians in care coordination, care progression, care consistency and CDI activities. Reviews and provides physician perspective for policies that related to care coordination, patient access, CDI. Collaborates with appropriate departments, leaders, and committees to meet established goals for physician participation and compliance with expectations. Designs, implements, and directs system wide programs for Infection Control, Supports the Mission of CHE Trinity Health and Holy Cross Health.

What We Offer:

Benefits, Free parking, employee discounts.

Quality of Life: Flexible work schedules to support a healthy work-life balance.
Advancement: Opportunities for professional growth within the organization.
Location: Holy Cross Health operates two hospitals and four healthcare centers, all within a short driving distance from Washington, DC, and Baltimore, MD.

ESSENTIAL FUNCTIONS
1.   Inpatient/Observation Clinical Optimization: Serves as physician expert and provides support to care team and care coordination staff regarding utilization decisions including screening for appropriateness of hospitalization, LOC status, LOS management, continued stay decisions, clinical review of patients, utilization review activities, resource utilization/management, denial management issues, discharge planning (DP) advise and quality issues. Functions as a consultant and resource to other Physician Advisors and primary (attending) physicians. 
2.   Collaboration: Supports care team to ensure appropriate patient placement, care/discharge/etc. Ensures medical staff have understanding and compliance with applicable areas of expertise. 
3.   Clinical Documentation Improvement: Provides instructional input and education to medical staff and CDI staff. 
4.   Regulatory and Accreditation: Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR) LOC and clinical documentation.  
5.   Revenue Excellence: conduct verbal and written Peer to Peer reviews to assist with appeals of denied or downgraded coverage determinations by managed care, commercial payers, and recovery audit contractors.

MINIMUM QUALIFICATIONS
Graduate of an accredited medical school
•   Completion of specialty residency (e.g., Internal Medicine, Emergency Medicine) 

Experience: 
•   Five years recent experience in clinical practice in a hospital strongly preferred
•   Previous experience as a physician advisor preferred
•   Experience with participation in medical staff committees preferred
•   Current active medical staff privileges

License, Registration or Certification Required: 
•   Board Certified/Eligible Physician licensed in Maryland the applicable states 

Knowledge, Skills and Abilities:
•   Strong clinical acumen
•   Knowledge of Care Management principles, processes, and their practical application
•   Working knowledge of third-party payer guidelines/medical necessity criteria (e.g., knowledge of admission criteria for all levels of care)
•   Understanding of approaches to denials management
•   Knowledge of clinical, quality, and administrative facets of the healthcare industry
•   Familiarity with clinical documentation requirements
•   Working knowledge of Centers for Medicare and Medicaid Services rules and regulations, and interest in building this knowledge through experience and partnership with Care Management
•   Excellent communication and presentation skills (both written and oral)
•   Teaching and coaching skills
•   Analytical ability and problem-solving skills
•   Working knowledge of electronic medical record
•   Knowledge of process improvement methodology
•   Demonstrated ability to work effectively within the medical staff structure
•   Demonstrated ability to work effectively in an inter-professional team
•   Ability to work effectively despite a potentially disruptive environment or peer resistance.
•   Willingness and ability to participate in ongoing education recommended by Local management leaders and/or Trinity Health. 

Rate of Pay: $98.65-$147.98

Pay is based on experience, skills and education.  Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

Holy Cross Health is an Equal Employment Opportunity (EEO) employer. Qualified applicants are considered for employment without regard to Minority/Females/disabled/Veteran (M/F/D/V) status

Holy Cross Health is a Catholic, not-for-profit health system that serves more than 240,000 individuals each year from Maryland's two largest counties - Montgomery and Prince George's counties. Our community is vibrant, active and diverse, where life is always moving. Holy Cross Health is continuously advancing, too, as a forward-thinking health system committed to helping our community members address their individual needs and goals to achieve a better quality of life. From hospitals and primary care sites, to specialty care and wellness programs, Holy Cross Health is accessible throughout the region to meet individuals on their path to good health.

Holy Cross Health has been a steward of our diverse community's health for more than 50 years, earning the trust of area residents. Our team of more than 4,100 employees, 1,575 community-based physicians and 425 volunteers works proactively each day to meet the needs of every individual we touch. And our mission and values mean that we uphold this commitment for every person, without regard for ability to pay. During the last five fiscal years, Holy Cross Health has provided more than $295 million in community benefit, including more than $169 million in financial assistance. 

Holy Cross Health is a member of Trinity Health, one of the largest Catholic health care organizations in the United States. Trinity Health is based in Livonia, Michigan.

Silver Spring is a town in Maryland with a population of 81,773. Silver Spring is in Montgomery County and is one of the best places to live in Maryland. Living in Silver Spring offers residents an urban feel and most residents rent their homes. In Silver Spring there are a lot of restaurants, coffee shops, and parks. Many families and young professionals live in Silver Spring and the public schools in Silver Spring are highly rated.

Silver Spring is the culture and art hub of Montgomery County and is home to colorful murals, inviting community destinations, and performance venues. Located directly north of Washington, DC, Silver Spring is the place to visit for a family-friendly outing, weekend trip with friends, or romantic getaway. Shop your way through the many retail options, have a group dinner at a new restaurant, or dance the night away at a concert performed by your favorite artist.

https://visitmontgomery.com/regions/silver-spring/

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. It is a family of 133,000 colleagues and more than 38,900 physicians and clinicians caring for diverse communities across 25 states. Nationally recognized for care and experience, the Trinity Health system includes 92 hospitals, 101 continuing care locations, the second largest PACE program in the country as well as many other health and well-being services. In fiscal year 2025, the Livonia, Michigan-based health system invested $2.9 billion in its communities in the form of charity care, community benefit and other programs and services. 

Our mission: We, Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. We support this mission by living our core values of Reverence, Commitment to Those Experiencing Poverty, Safety, Justice, Stewardship, and Integrity. Committed to recruiting talented physicians, we are looking for physicians who share our values and want to help us fulfill the health care needs of the communities we serve.

At Trinity Health, we value the physician relationship and focus on partnering with our physicians. Whether you are a practicing physician looking to relocate or a medical resident, we offer opportunities with the flexibility to fit your individual needs. If you would like to be part of Trinity Health, we encourage you to explore more at www.trinity-health.org.