Physician Advisor Cover Letter

I would like to submit my application for the physician advisor opening. Please accept this letter and the attached resume.

In the previous role, I was responsible for education to physicians and case managers on denial and payor trends, I and medical review criteria, documentation, and CMS/other regulatory requirements and updates.

Please consider my qualifications and experience:

• Interact with medical staff by seeking additional clinical information from physicians, discuss the patient’s needs, suggest alternative treatment options and recommend next steps
• Function as consultant and resource to primary (attending) physicians
• Participate in interdisciplinary care coordination rounds (as needed) and support care team communication and coordination activities
• Support care team, patient access center and nursing supervisors by assisting with patient placement decisions (as needed)
• Participate in weekly Clinical High Risk (CHR) meeting to discuss selected cases (e.g., outliers, care/discharge barriers) and makes recommendations
• Document patient care reviews, decisions and other pertinent information per hospital/ care coordination policies
• Maintain knowledge of regulation and accreditation requirements related to utilization review, discharge planning, level of care and clinical documentation
• Identify gaps in physician practice related to standards and regulations and develop action plans to address identified gaps in regulatory requirements

I submit this application to express my sincere interest in the physician advisor position.

Previously, I was responsible for education to physicians and other clinicians related to regulatory requirements, appropriate utilization, alternative levels of care, community resources, and end of life care.

Please consider my qualifications and experience:

• Experience in a Chief Medical Officer (CMO ) preferred
• Active Licensed physician
• Hospitalist or Intensivist experience preferred
• Graduate of an accredited medical school, preferably board certification in area of practice
• Broad knowledge with trust and respect of medical staff physicians
• MD/DO with current state licensure, Board Certified
• Basic Current knowledge of CMS rules and regulations, as they pertain to case management, utilization management, and denial management in the acute care setting
• Demonstrated effective clinical acumen for appropriate/effective utilization of services/resources for safe, high-quality patient care and outcomes

I submit this application to express my sincere interest in the physician advisor position.

In the previous role, I was responsible for education to physicians and other clinicians on regulatory requirements, appropriate utilization of alternate levels of care, community resources and end of life care.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Provide education and information to clinical groups regarding changes to practice and/ or standards
• Support quality improvement projects to streamline processes and address gaps
• Strive to achieve the goal of accreditation through the Accrediting Body requirements specific to care coordination are fulfilled but also understand the linkage between care coordination department’s requirements and those of the integrated delivery system
• Knowledge of Microsoft PowerPoint, including creating presentations
• Excellent clinical review and critical analysis skills to conduct peer review audits
• Directly communicates with care managers, attending physicians, and payers to resolve denial management issues timely
• Concurrently provide both verbal and written timely communication to third party payers and PA Medical Assistance for appeals
• Maintains current knowledge of government regulations

I submit this application to express my sincere interest in the physician advisor position.

In the previous role, I was responsible for review and advice for utilization management policies, criteria, and protocols.

Please consider my qualifications and experience:

• Active member of the Utilization Management Committee
• Review of referred cases for appropriate level of care utilizing CMS regulations and medical necessity
• Review of medical record for Skilled Nursing Facility (SNF) qualifying stay
• Review of one day stay Medicare cases for appropriate level of care, as per Reimbursement Integrity Team Lead
• Documentation of level of care for referred determination in utilization management documentation system
• Proficient with computers and programs integral to documentation and coding
• Demonstrates understanding of South Shore Health System’s culture and program goals
• Board certification and medical licensure

Please consider me for the physician advisor opportunity. I am including my resume that lists my qualifications and experience.

Previously, I was responsible for support and educate internal clinical and non-clinical staff to foster understanding of the principles associated with appropriate cardiac diagnoses, treatments and management.

I reviewed the requirements of the job opening and I believe my candidacy is an excellent fit for this position. Some of the key requirements that I have extensive experience with include:

• Knowledge of standardized clinical criteria sets, disease and population management, evidence- based practice guidelines and their relationship/application to the care coordination process
• Complete medical record and CDI processes
• Prior experience in a health-related field is preferred
• This job is paid on an hourly basis for part-time work
• Experience with conferring with senior stakeholders
• Experience with advising the client on the impact of new legislation or new technologies relevant to their activity
• Doctor of Medicine (MD) or Osteopathy (DO)
• Board Eligible or Board Certified (BE or BC)