22 jobs in GBMC HealthCare

GBMC HealthCare in Baltimore, Maryland seeks an Executive Director of Access to lead patient access operations. This role involves ensuring effective connectivity for patients to care through optimizing call center and access strategies.

The ideal candidate will have a Master's degree and over 7 years in a senior healthcare role, managing key performance metrics and leading operational changes to enhance patient experiences across service lines.

Under the co-direction of the Executive Director of Reimbursement, Chief Medical Information Officer, and Associate Chief Medical Officer, the Physician Advisor Director provides leadership to a team of associate Physician Advisors that supports case management, social work, coding team, utilization review, population health, and other clinical members to provide cost efficient, high quality inpatient and observation care at GBMC Hospital. This management includes level of care reviews, all denial reviews and appeals management for all hospital patients. The Physician Advisor Director is responsible for clinical direction of these services and shall be responsible for the development, implementation and oversight of policies and procedures as they apply to the provision of assigned services. The Physician Advisor Director is a 0.75 to 1.0 FTE and will report directly to the Associate Chief Medical Officer.

• Graduate of an accredited medical program. Additional education in utilization and quality management through continuing medical education program and self-study

• Licensed as a physician in the State of Maryland
• Board Certified by the American Board of Internal Medicine, or other certifying Board as deemed appropriate by Chief Executive Officer.

• 2-4 years of recent experience and expertise in Utilization Management and Clinical Quality Management and 5 years of direct clinical experience.
• Has knowledge of Pay for Performance/VBP initiatives and incentives.

• A high level of interpersonal skills to allow effective communications and interaction with a wide variety of hospital personnel, physicians, and the general public
• Documented interest and experience in the education and quality improvement needs for the various service lines under his/her responsibility
• Familiarity with Clinical Documentation requirements and working knowledge of Centers for Medicare and Medicaid services, rules and regulations.

• Serves as physician expert and provides support to care team and Case Management, UR and Social Work staff regarding utilization decisions including screening for appropriateness of hospitalization, Level of Care (LOC), patient billing status management, Length of Stay (LOS) management, continued stay decisions, clinical review of patients, utilization review activities, resource utilization/management, denial management issues, transitions of care/discharge planning (TOC/DP) advice, and quality of care issues
• Works productively with all department leaders to ensure that clinical care is consistent with current scientific advances and best evidence existing in published clinical literature or as established by recognized professional associations.
• Provides input at least annually for strategic and operational planning purposes and an assessment of Case Management, UR and DC/TOC efficiency and effectiveness.
• Makes recommendations to the Hospital’s administration regarding the use of hospital personnel, any necessary equipment, and general quality standards of patient care.
• Provides leadership and support to develop and maintain effective UM coverage at all points of entry to the Hospital (POE’s). POE process should be inclusive of UR appropriateness, admission avoidance, discharge planning and internal/external resource utilization.
• Supports effort to formalize PA, CM, and Revenue Cycle department operational integration (weekly or bi-weekly) to ensure claims are paid, and that medical necessity issues are addressed concurrently.
• Review denials for patients in the hospital or recently discharged and conduct peer-to-peer consultations with attending physicians as appropriate.
• Review requests for accommodation codes, review daily report for status change for Medicare patients and other requests for status and makes recommendations/decisions based on consultations with attending physician.
• Reviews all denials and is responsible for the administration of the appeals process, including completion of appeal letters, communication & education of medical staff.
• Provide oversight of the development and approval of all operating policies and procedures for Physician Advisor services in conjunction with the responsible Administrator.
• Represents, or appoints designee to represent the hospital’s interests to external organizations concerned with denial management/Medicare or insurance providers.
• Collaborates with PA peers/mentors on an inter-rater reliability (IRR) process to capture standardized policies and procedures that can be used to support overall program strategy and utilization management approach.
• Provides education to physicians and other clinicians related to regulatory requirements, appropriate utilization, and alternative levels of care
• Educates specific medical staff departments (Hospitalists, Surgery, Residents, etc.) at department meetings regarding correct disease reporting, ICD code assignment, capture of severity and overall hospital reimbursement policies.
• Liaison to Utilization Review, HIM/CDI, EHR and various quality teams throughout the hospital
• Assists in the dissemination of Best Practice information.
• Ensures commitment to GBMC service excellence standards and goal of being a best-in-class provider with:
• Maintaining positive attitude and professional appearance
• Respecting others
• Assisting others
• Doing what is right
• Displaying courteous behavior
• Promoting service excellence education and application of principles
• Consistently sharing physician-specific service results
• Ensuring patient satisfaction with physicians and physician extenders which exceeds nation standards
• Chairs the monthly Utilization Management (UM) Medical Staff Committee.
• Moderates and/or resolves conflict among physicians and other health care providers. Provide support for staff in difficult situations.
• Works to ensure initial or continued accreditation through the following: Collaborate with colleagues in quality and other departments to ensure all accrediting body requirements are met.
• Participate in regulatory or accreditation reviews or audits.
• Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), Discharge Planning, Level of Care, patient billing status management, and clinical documentation.
• Collaborates with hospital and quality department leadership to: a. Ensure medical staff’s understanding and compliance with accreditation and regulatory management activities, b. Identify gaps in physician practice related to standards and regulations, c. Develop action plans to address identified gaps in regulatory requirements, d. Provide education and information to clinical groups regarding changes to practice and/or standards, e. Support quality improvement projects to streamline processes and address gaps, f. Prepare for surveys and participate in surveys, as appropriate.
• Collaborates with CM, Clinical Documentation Integrity (CDI), and Revenue Cycle on strategic initiatives to improve the efficiency of the PA program.

I will treat everyone with courtesy. I will foster a healing environment.

• Treats others with fairness, kindness, and respect for personal dignity and privacy
• Listens and responds appropriately to others’ needs, feelings, and capabilities

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

• Meets and/or exceeds customer expectations
• Actively pursues learning and self-development
• Pays attention to detail; follows through

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time

I will be engaged and collaborative. I will keep people informed.

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive way
• Seeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others

I will always act with honesty and integrity. I will protect the patient.

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

• Embraces change and improvement in the work environment
• Continuously seeks to improve the quality of products/services
• Displays flexibility in dealing with new situations or obstacles
• Achieves results on time by focusing on priorities and manages time efficiently

$148,140.24 - $266,652.44

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Under general supervision is accountable for the clinical management of patients.

Graduate of an accredited medical program.

Licensed as a physician in the State of Maryland. Complete required CME credits for continuous licensure. Board Certified by the appropriate board consistent with the physician’s specialty. Need to decide on CPR.

Not Applicable.

• A high level of analytical ability required for assessing patients and implementing appropriate interventions.
• Substantial interpersonal skills required to effectively interact with staff, physicians, patients, and family members.

Assumes responsibility for the initial evaluation and treatment of patients in assigned areas.

• Performs initial history and physical and documents same appropriately in Electronic Medical Record.
• Writes standard orders in accordance with hospital policy.
• Writes appropriate orders related to pre-existing conditions.
• Discusses physical and/or emotional findings of patient, which may interfere with care of the patient with provider colleagues and practice staff as necessary.

Evaluates patient progress on a continuing basis and in and alters treatment modalities as needed.

• Evaluates medical, social and educational needs of assigned patients.
• Initiates referral to appropriate ancillary departments and community resources based on patient need and documents on the progress note.
• Writes progress notes for each visit documenting pertinent information regarding patient progress and treatment regime.
• Writes orders appropriate to the patient's care requirements in compliance with existing contract.
• Establishes medical diagnoses in compliance with contract.
• Makes immediate referral of acute and or life‑tending patient conditions to emergency department or specialist physician as needed. Documents physical findings and treatment plan pertaining to same.

Performs activities to meet patient/family educational needs.

• Participates actively in health teaching of patient and family to include preventative health care as well as current medical condition and treatment regime. Evidence of same by documentation on progress note and/or established flow sheet.
• Plans and reviews home care instructions with patient and family if needed. Include needs for service provided by community resources and hospital based ancillary services.

Assumes responsibility for utilizing opportunities for educational advancement by pursuing activities to meet identified educational needs and those required for continued certification as well as attending mandatory in service training.

I will treat everyone with courtesy. I will foster a healing environment.

• Treats others with fairness, kindness, and respect for personal dignity and privacy
• Listens and responds appropriately to others’ needs, feelings, and capabilities

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

• Meets and/or exceeds customer expectations
• Actively pursues learning and self‑development
• Pays attention to detail; follows through

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time

I will be engaged and collaborative. I will keep people informed.

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive waySeeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others

I will always act with honesty and integrity. I will protect the patient.

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

• Embraces change and improvement in the work environment
• Continuously seeks to improve the quality of products/services
• Displays flexibility in dealing with new situations or obstacles
• Achieves results on time by focusing on priorities and manages time efficiently

$1,000.00 - $675,000.00

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

GBMC HealthCare in Baltimore is seeking a physician responsible for the clinical management of patients. This role requires evaluating initial patient conditions and managing treatment plans within compliance guidelines.

Candidates must be licensed in Maryland and board certified in their specialty. The pay range for this position is between $1,000.00 and $675,000.00, and the final salary will depend on qualifications and experience.

Responsible for physician recruitment, retention, supervision, practice development/management. Support the development and implementation of standardized care protocol, patient safety/quality initiative. Participate as an active member of the hospital-based physician practice.

Graduate of an accredited medical program

Minimum of 5 years of experience as hospitalist and leadership role in group practice

Board Certified in Internal Medicine

• Fundamental knowledge related to hospital-based physician practice is required

• Partner with Clinical Nurse Manager(s) to assess progress on goals and to work on areas where physician engagement is required to meet goals.
• Championing of meaningful change, participation in developing new processes/procedures that improve efficiency and effectiveness of patient care
• Soliciting, listening for and communicating feedback among stakeholders, including other physicians, nursing, patients and administration in collaboration with the Nurse Manager
• Consensus building between physicians, nursing staff, and administration in collaboration with the Nurse Manager
• Review with the Clinical Nurse Manager the long length of stay patients on the unit and help make dispositions with the attending physicians when possible.
• Assistance with Joint Commission readiness efforts
• Facilitate the triaging of patients when necessary to promote patient flow
• Facilitate the follow up of quality concerns for patients moving to the outpatient setting.
• Ensuring that unit case manager and discharge planners have provided patients being discharged with the proper follow up appointments, medications and home needs
• Collaborate, by attending regular meetings with other unit medical directors and clinical nurse managers to assess best practices
• Perform other duties or responsibilities related to patient care as reasonably necessary or as reasonably requested.

Able to perform daily tasks necessary for management of hospitalized patients

Normal patient care environment with possible exposure to excessive noise, dust, temperature.

Exposure to adverse working conditions due to performance of patient care activities, and exposure to communicable diseases.

GBMC Medical Staff Privileges

$0.01 - $400.00

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Under general supervision is accountable for the clinical management of patients.

Graduate of an accredited medical program.

• Licensed as a physician in the State of Maryland. Complete required CME credits for continuous licensure.
• Board Certified by the appropriate board consistent with the physician’s specialty.
• Need to decide on CPR

Not Applicable

• A high level of analytical ability required for assessing patients and implementing appropriate interventions.
• Substantial interpersonal skills required to effectively interact with staff, physicians, patients, and family members.

Assumes responsibility for the initial evaluation and treatment of patients in assigned areas.

• Performs initial history and physical and documents same appropriately in Electronic Medical Record.
• Writes standard orders in accordance with hospital policy.
• Writes appropriate orders related to pre-existing conditions.
• Discusses physical and/or emotional findings of patient, which may interfere with care of the patient with provider colleagues and practice staff as necessary.

Evaluates patient progress on a continuing basis and in and alters treatment modalities as needed.

• Evaluates medical, social and educational needs of assigned patients.
• Initiates referral to appropriate ancillary departments and community resources based on patient need and documents on the progress note.
• Writes progress notes for each visit documenting pertinent information regarding patient progress and treatment regime.
• Writes orders appropriate to the patient's care requirements in compliance with existing contract.
• Establishes medical diagnoses in compliance with contract.
• Makes immediate referral of acute and or life‑treating patient conditions to emergency department or specialist physician as needed. Documents physical findings and treatment plan pertaining to same.

Performs activities to meet patient/family educational needs.

• Participates actively in health teaching of patient and family to include preventative health care as well as current medical condition and treatment regime. Evidence of same by documentation on progress note and/or established flow sheet.
• Plans and reviews home care instructions with patient and family if needed. Include needs for service provided by community resources and hospital based ancillary services.

Assumes responsibility for utilizing opportunities for educational advancement by pursuing activities to meet identified educational needs and those required for continued certification as well as attending mandatory in service training.

Respect

I will treat everyone with courtesy. I will foster a healing environment.

• Treats others with fairness, kindness, and respect for personal dignity and privacy
• Listens and responds appropriately to others’ needs, feelings, and capabilities

Excellence

I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

• Meets and/or exceeds customer expectations
• Actively pursues learning and self‑development
• Pays attention to detail; follows through

Accountability

I will be professional in the way I act, look and speak. I will take ownership to solve problems.

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time

Teamwork

I will be engaged and collaborative. I will keep people informed.

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive way
• Seeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others

Ethical Behavior

I will always act with honesty and integrity. I will protect the patient.

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers

Results

I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

• Embraces change and improvement in the work environment
• Continuously seeks to improve the quality of products/services
• Displays flexibility in dealing with new situations or obstacles
• Achieves results on time by focusing on priorities and manages time efficiently

$1,000.00 - $675,000.00

Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.

GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

Under general supervision is accountable for the clinical management of patients.

Education

Graduate of an accredited medical program.

Licensures/Certifications

Licensed as a physician in the State of Maryland. Complete required CME credits for continuous licensure.

Board Certified by the appropriate board consistent with the physician’s specialty.

Need to decide on CPR

Experience

Not Applicable

Skills

• A high level of analytical ability required for assessing patients and implementing appropriate interventions.
• Substantial interpersonal skills required to effectively interact with staff, physicians, patients, and family members.
  
  

• Performs initial history and physical and documents same appropriately in Electronic Medical Record.
• Writes standard orders in accordance with hospital policy.
• Writes appropriate orders related to pre-existing conditions.
• Discusses physical and/or emotional findings of patient, which may interfere with care of the patient with provider colleagues and practice staff as necessary.
  
  

• Evaluates medical, social and educational needs of assigned patients.
• Initiates referral to appropriate ancillary departments and community resources based on patient need and documents on the progress note.
• Writes progress notes for each visit documenting pertinent information regarding patient progress and treatment regime.
• Writes orders appropriate to the patient's care requirements in compliance with existing contract.
• Establishes medical diagnoses in compliance with contract.
• Makes immediate referral of acute and or life-threatening patient conditions to emergency department or specialist physician as needed. Documents physical findings and treatment plan pertaining to same.
  
  

• Participates actively in health teaching of patient and family to include preventative health care as well as current medical condition and treatment regime. Evidence of same by documentation on progress note and/or established flow sheet.
• Plans and reviews home care instructions with patient and family if needed. Include needs for service provided by community resources and hospital based ancillary services.
  
  

• Treats others with fairness, kindness, and respect for personal dignity and privacy
• Listens and responds appropriately to others’ needs, feelings, and capabilities
  
  

• Meets and/or exceeds customer expectations
• Actively pursues learning and self-development
• Pays attention to detail; follows through
  
  

• Sets a positive, professional example for others
• Takes ownership of problems and does what is needed to solve them
• Appropriately plans and utilizes required resources for various job duties
• Reports to work regularly and on time
  
  

• Works cooperatively and collaboratively with others for the success of the team
• Addresses and resolves conflict in a positive way
• Seeks out the ideas of others to reach the best solutions
• Acknowledges and celebrates the contribution of others
  
  

• Demonstrates honesty, integrity and good judgment
• Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers
  
  

• Embraces change and improvement in the work environment
• Continuously seeks to improve the quality of products/services
• Displays flexibility in dealing with new situations or obstacles
• Achieves results on time by focusing on priorities and manages time efficiently