Come interview with us this week for a chance to join Athena's amazing team of passionate and experienced Clinical Supervisors! #LCSW and #LMHC required.
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Another great opportunity in partnership with Jackson Physician Search. If you aspire to become a Chief Medical Officer #CMO one day, the skills you learn as Physician Advisor or as an Associate CMO are fantastic to have in your toolbox. If you think you are about to stretch out of your comfort zone when applying for these roles, then you have mastered your current one and you are ready to move on. #growthmindset #leadership #physicianleadership
Physician Leader and Executive/President and CEO American College of Physician Advisors/Chief Medical Officer (CMO) SD Medicaid/Clinical Professor Internal Medicine/Author/Speaker
Special thanks to everyone who participated in or attended the #leadership panel at #NPAC2024. Relatedly, this is an excellent example of a potential "next step" position for a #physicianadvisor. It is an Associate Chief Medical Officer roll that calls for experience with: Utilization Review Improving Quality Metrics Being a Change Agent with physician performance Clinical Documentation And qualifications include "Working with Managed Medicaid and Medicare Advantage!" https://lnkd.in/gVfHBEZT (PS Jackson Physician Search you'll find lots of physician advisors looking for their next roles on the American College of Physician Advisors job board https://lnkd.in/gkBJYGfs)
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Value-Based Care Operator and Advisor for CEOs, CMOs, & CMIOs | I design scalable population health strategies incorporating people, process and technology to save lives, to expand access, & to reduce the cost of care.
How To Evaluate The Prior-Auth Process It is difficult to know how to look at the prior-authorization process as there is very little in the way of peer-reviewed literature on the subject. Below are 6 areas to consider when evaluating the prior-authorization process from a payer perspective. This is what I use in engagements with payers to guide CMOs, CEOs and Medical Directors in determining which services and/or procedures require no prior-authorization, go to auto-adjudication, or clinical review. 1) Risk to Patient Safety 2) Evidence of Treatment Efficacy 3) Risk of Overutilization, Underutilization, Fraud, or Abuse 4) Payer and/or Regulatory Requirements 5) Medical Expense Trends 6) Operating Cost to Adjudicate I have mixed feelings about the prior-authorization process. I’ve seen it check physicians who appeared to be practicing outside of evidenced-based clinical guidelines. I’ve also seen the legitimate medical needs of patients be delayed as the result of this process. Please let me know what you think about my recommendations. Feel free to like or comment. About the author: Jeff Lewis is an RN consultant at NextGen Executive Consultants LLC American Medical Association American Hospital Association American Nurses Association UnitedHealthcare Elevance Health Humana Cigna Healthcare
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Senior Physician Executive| Vanderbilt | Former Aerospace Engineer | Neurosurgeon | Revolutionizing Healthcare with AI | Leveraging Technology | Operations | Husband & Dad to 3
Interesting article about turf wars in medicine. Two thoughts: 1) I have always wondered why every health system has on its C-suite level: a) Chief Medical Officer b) Chief Nursing Officer c) Chief Financial Officer d) Chief Legal Officer e) Chief Consumer Officer f) Chief Technology Officer Where is the Chief Pharmacy Officer at the C-suite? Look up any of these large provider organizations and you will find none! It’s appalling that our pharmacy colleagues occupy such a large portion of our clinical delivery not to mention about 15-20% of any system’s revenue but are not at the table. Which leads me to the crux of the article. Respect and inclusivity should start at the top. Representation matters. 2) I am not an AMA member, but as a Neurosurgeon who works very closely with pharmacists, I have to agree with my pharmacy colleagues. Physicians especially PCPs, are burned out with overwhelming amounts of data and patient demands. Medicine is a team sport, I welcome any help my pharmacy colleagues can afford me lessen my cognitive overload! As some of us smartly incorporate AI into healthcare, is AMA going to complain about AI-scope creep too? EE #aihealthcare Michael Hogue #medicineisateamsport #AmericanPharmacistsAssociation #pharmacyatcsuite #ama Jesse Ehrenfeld MD MPH
Pharmacists confront AMA's 'scope creep' stance
beckershospitalreview.com
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🚀 Exploring Top Compliance Challenges for Specialty Products in Life Sciences 🧪 As life sciences compliance professionals, staying ahead of the curve is essential in today's dynamic landscape. Some key compliance challenges facing Patient Services for Specialty Products were recently delved into during a panel discussion at the Compliance Congress for Specialty Products and here are the highlights: 🤝Patient Interactions: · Patient engagement in the US is common and a growing trend, but caution is essential. · Primary principle: Do not disrupt the HCP/patient relationship. · Thoroughly train personnel involved in patient interactions. · Customize messaging to address cultural and community concerns. 🤯Patient Advocacy and Independence: · Operate alongside patient advocacy groups while maintaining independence. · Avoid any appearance of controlling patient advocacy activities. · Adapt strategies based on the sophistication of the advocacy organizations you collaborate with. · Hiring personnel with a background in patient advocacy groups requires clear education around the regulatory boundaries that will now guide their actions and interactions. 👩⚕️Nurse Educators' Role: · Monitor nurse educators to prevent interference with the HCP/patient relationship. · First-line managers play a critical role in risk prevention. · Define clear boundaries for nurse educators' responsibilities. 💬Medical/Commercial Interactions: · Exercise caution in interactions between medical and commercial teams. · While there's no specific law, consider the implications of these interactions. · Define roles, especially at the field levels. · Implement a robust needs assessment process to address activities where Commercial and Medical are in attendance and ongoing monitoring. 💡Navigating Specialty Products: · Consider inducement questions when dealing with rare diseases. · Nurse educators' roles can vary widely and require careful management. · Medical advocacy presents complex challenges that require clear guidance. 🔗 Holistic Understanding: · Gain a comprehensive understanding of all patient interactions. · Establish strong relationships with patient advocacy groups. · Flexibility and adaptability are crucial as unforeseen scenarios may arise. Remember, navigating compliance challenges in specialty products requires a multifaceted approach. Stay informed, collaborate, and prioritize transparency to ensure your organization's compliance efforts remain steadfast. 🧬 #LifeSciencesCompliance #SpecialtyProducts #ComplianceChallenges
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PwC Asia Pacific Health Industries Leader * Surgeon * Doctorpreneur * Consultant * Futurist * Thought Leader * Advisor * Researcher * Mentor
Do doctors need to better understand the “business” side of Medicine? Yes, we absolutely do! While I am not going to judge Optum or any other Provider for that matter based on the lengthy article below, the one key message I personally take away is that it is no longer sufficient for clinicians today to study and practice Medicine or Surgery like the good old days in order to complement what are usually non-clinician administrators in almost every #healthcare system in the world. It will be imperative for all us clinicians to understand the processes behind the care we work so tirelessly for years to deliver. A young doctor that I mentor asked me the other day in a similar context, “Where do I start?” I replied, “Perhaps with the ABCs. Learn about accounting, billing, coding. And the importance of getting these right. However, and most importantly, always remain #honest and #transparent for ultimately, it comes down to just three things, #compassion for our patients, #trust and #ethics.” Perhaps it is time that medical schools seriously reconsider their curriculums and rather than teach solely on the anatomy, physiology and pathology of the human body, about health systems, too. Would you agree? Professor Shafi Ahmed Cathal Kelly Joanne Yoong Jeremy Lim Rafael J. Grossmann, MD, MHDS, FACS Thiru Thirumoorthy HiruX Pte. Ltd. https://lnkd.in/gGtmw64H.
Whistleblower Releases Audio, Files Complaint: Cites Medical Billing Plot at Optum
https://www.theexaminernews.com
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ICYMI: #AdvancedPractitioner #AlliedHealth Transitioning from a Non-Clinical to a Clinical Role: Clinical positions carry a higher level of responsibility and stress than most jobs, but moving from a non-clinical to a clinical role can be a rewarding career path. Here are some best-practice guidelines and tips to help you navigate the unique challenges and thrive in your new position.
Transitioning from a Non-Clinical to a Clinical Role
https://www.hospitalrecruiting.com
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Writer. Author. Advocate. Speaker. Dx IQ Columnist & Board Member at SIDM. Board Member at Pen Parentis.
What does the term Patient Engagement mean to you? To your work as a medical professional or patient advocate or to your life as a person we want to engage? I’m asking seriously because on LinkedIn, where #patientengagement is a very popular hashtag, it seems there is little to no agreement on what it means. For some, it’s a method of increasing #customers; for others, a way to raise #patientsatisfaction scores; still others are hoping to teach patients how to advocate for themselves; or empower them; or make #shareddecisionmaking the gold standard. So, please, share your voice and comment below how YOU define the term. Maybe, we just need alternate terms... Let’s see if we can come to a consensus. Keep it simple please. State your job/role and your definition. We can upvote with likes and other emoticons. Want to get the ball rolling: Suzanne Schrandt Susan Brown Sheridan Dan Berg Grace Cordovano, PhD, BCPA Stacy Hurt, MHA, MBA🌻 Helen Haskell Kamili Wilson Steven Coffee Jennie Ward-Robinson, Ph.D. Gerald Castro Ronald W. Armando Nahum Patients for Patient Safety US Patients Know Best Patient Partner Innovation Community Lisa McCorkell Claire Sachs Erika Hanson Brown Io Dolka Jenneh Rishe BSN, RN Jaime Seltzer Cindi Gatton Dr. Knitasha V. Washington DHA FACHE Lisa McGiffert MaryElizabeth Williams https://lnkd.in/eRYWAK8S (BTW subscribing to my substack is free) #physician #doctor #healthcare #patient #PatientAdvocate #nurse #MedResearcher #MedicalResearcher #ClinicalResearcher #Surgeon #Hospitalist #Marketing #Medicine #MedicalSchool #Hospitals
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Patient engagement is listening and planning care together. The opposite is authoritative healthcare where we give orders and expect obedience, or a sales approach where we don’t care if it helps as long as we make a profit. Patient engagement is like our conscience in healthcare because they will tell us when we are not listening.
Writer. Author. Advocate. Speaker. Dx IQ Columnist & Board Member at SIDM. Board Member at Pen Parentis.
What does the term Patient Engagement mean to you? To your work as a medical professional or patient advocate or to your life as a person we want to engage? I’m asking seriously because on LinkedIn, where #patientengagement is a very popular hashtag, it seems there is little to no agreement on what it means. For some, it’s a method of increasing #customers; for others, a way to raise #patientsatisfaction scores; still others are hoping to teach patients how to advocate for themselves; or empower them; or make #shareddecisionmaking the gold standard. So, please, share your voice and comment below how YOU define the term. Maybe, we just need alternate terms... Let’s see if we can come to a consensus. Keep it simple please. State your job/role and your definition. We can upvote with likes and other emoticons. Want to get the ball rolling: Suzanne Schrandt Susan Brown Sheridan Dan Berg Grace Cordovano, PhD, BCPA Stacy Hurt, MHA, MBA🌻 Helen Haskell Kamili Wilson Steven Coffee Jennie Ward-Robinson, Ph.D. Gerald Castro Ronald W. Armando Nahum Patients for Patient Safety US Patients Know Best Patient Partner Innovation Community Lisa McCorkell Claire Sachs Erika Hanson Brown Io Dolka Jenneh Rishe BSN, RN Jaime Seltzer Cindi Gatton Dr. Knitasha V. Washington DHA FACHE Lisa McGiffert MaryElizabeth Williams https://lnkd.in/eRYWAK8S (BTW subscribing to my substack is free) #physician #doctor #healthcare #patient #PatientAdvocate #nurse #MedResearcher #MedicalResearcher #ClinicalResearcher #Surgeon #Hospitalist #Marketing #Medicine #MedicalSchool #Hospitals
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Within the behavioral healthcare industry there were times I was assigned roles to supervise credentialed staff. After hearing the concerns of the staff I supervised, I came into agreement that my personal experience inserted into how the staff should operate in this field was not only offensive , but undermined their every effort . I chose to trust in their competence! I was motivated and supported to return to school and increase my insight while obtaining the competence and credentials. I am grateful and humbled to say I achieved that. Supervisors of clinical and medical staff in behavioral healthcare should be credentialed for multiple reasons: 1. Ensuring competence: Supervisors should have the same rigorous training, education, and assessment to demonstrate their competence. This ensures that they possess the necessary knowledge, skills, and experience to effectively supervise and guide clinical and medical staff. 2. Maintaining ethical standards: Credentialing and practicing within scope help supervisors uphold ethical standards in behavioral healthcare. They are required to follow the professional codes of conduct and ethical guidelines specific to their field. This knowledge equips them to guide their staff in ethical decision-making, maintaining client confidentiality, and promoting ethical behavior throughout the organization. 3. Ensuring client safety and well-being:. By being credentialed and practicing within their scope, supervisors can effectively monitor and assess the practice of their employees. They can identify potential risks that may impact the quality of care provided to clients. 4. Facilitating professional development: Credentialed supervisors who practice within their scope can support the professional development of their supervisees. They can provide guidance, mentorship, that is welcomed for learning and growth. 5. Accountability and liability: Credentialed supervisors who practice within their scope are accountable for their actions and decisions. They understand the legal and regulatory requirements and do not have to rely on external agencies to ensure compliance . They are able to mentor staff and ensure the agency adheres to these standards. This minimizes the risk of potential legal and ethical issues for both the organization and the clients. Credentialing and practicing within scope are essential for supervisors in behavioral healthcare to maintain competence, to uphold ethical standards, ensure client safety, facilitate professional development, and uphold accountability and liability.
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📣 Hello from the InClinic family! We're passionate about transforming healthcare into a system that's more patient-centric, proactive, and personalized. Prevention, we believe, should be the norm, not the exception. One of the ways we make a difference is by partnering with medical practices and ACOs. Through our comprehensive care management services, we help these organizations streamline operations and improve patient outcomes. Exciting news! Our team is growing. We recently welcomed 10 clinical pharmacist fellows, 2 PGY1 pharmacy residents, and 9 clinical pharmacists. Each one brings unique skills and perspectives that strengthen our ability to innovate and deliver top-tier care. As they embark on their journey with us, they're spending time understanding the 'why' behind our work and preparing to make their contributions to a more efficient, personal, and accessible healthcare system. Are you a medical practice or an ACO in need of support? We'd love to collaborate! Reach out to us. Let's work together towards a future where everyone has access to quality, personalized healthcare. #InClinic #healthcareinnovations #patientcentric #caremanagement #teamgrowth #collaboration #ACOs #medicalpractices #chroniccaremanagement #chroniccare #remotepatientmonitoring #medicalpracticemanagement #healthcarecollaboration #populationhealth #populationhealthmanagement #integratedcare #valuebasedcare #primarycare #primarycarephysicians
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