Physician Anesthesiology - Competitive Salary
Company: CommonSpirit Health
Location: Englewood
Posted on: March 17, 2026
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Job Description:
Job Description Job Summary and Responsibilities This is a
remote position As the Utilization Management Physician Advisor
(PA), the PA conducts clinical case reviews referred by case
management staff and/or other health care professionals to meet
regulatory requirements and, in accordance with the hospital’s
objectives for providing quality patient care, to assure effective
and efficient utilization of health care services. The PA
communicates remotely with case and utilization management to
discuss selected cases and make recommendations regarding level of
care, as well as, communicates remotely with medical staff members
and medical directors of third-party payers to discuss the needs of
patients and options/alternatives for care. The PA acts as a
consultant to, and resource for, attending physicians regarding
their decisions relative to appropriateness of hospitalization,
appropriate level of care for initial hospitalization and continued
stay days, clinical documentation, and use of healthcare resources.
The PA further acts as a resource for the medical staff regarding
federal and state utilization and quality regulations. The PA must
demonstrate interpersonal and communication skills and must be
clear, concise and consistent in the message to all constituents.
Key Responsibilities Conducts medical record review in appropriate
cases for medical necessity of hospital admission, continued
hospital stays, adequacy of discharge planning and quality care
management. Understand the intricacies of the Medicare Inpatient
Prospective Payment System (IPPS) to make medical determinations on
severity of illness, acuity, risk of mortality, and communicate
with treating physicians in cooperation with the utilization team
and health information staff. Understand the intricacies of
ICD-9-CM, ICD-10-CM/PCS, MS-DRG, and APR-DRG. Contacts Case and
Utilization Management Teams: Makes telephonic/electronic contacts
with case and utilization management to discuss clinical aspects of
hospital encounters, as well as, medical necessity and appropriate
levels of care. Contacts Attending Physicians: Makes
telephonic/electronic contacts with Attending Physicians to discuss
clinical aspects of hospital encounters, as well as, medical
necessity and appropriate levels of care. Discussion may also
include education for improved clinical documentation, in addition
to, governmental and commercial guidelines for reimbursement.
Conducts Peer to Peer discussions with payers as needed. Job
Requirements MD or DO required Unrestricted license in field of
practice. Minimum of 1 year of experience as a Physician Advisor
preferred. Minimum of 5 years of clinical practice required.
Experience performing Peer to Peer Reviews, preferred Broad-based
knowledge regarding clinical practice. Broad knowledge base with
trust and respect of medical staff physicians. In-depth knowledge
of CMS regulations, including understanding of the 2-midnight rule.
Utilization management experience. Education in quality and
utilization management through continuing medical education
programs and self-study. Knowledge of and practical use of good
business English, spelling, arithmetic, practices and the ability
to communicate effectively using written and verbal skills. LI-CSH
LI-Remote Where You'll Work Inspired by faith. Driven by
innovation. Powered by humankindness. CommonSpirit Health is
building a healthier future for all through its integrated health
services. As one of the nation’s largest nonprofit Catholic
healthcare organizations, CommonSpirit Health delivers more than 20
million patient encounters annually through more than 2,300
clinics, care sites and 137 hospital-based locations, in addition
to its home-based services and virtual care offerings. CommonSpirit
has more than 157,000 employees, 45,000 nurses and 25,000
physicians and advanced practice providers across 24 states and
contributes more than $4.2 billion annually in charity care,
community benefits and unreimbursed government programs. Together
with our patients, physicians, partners, and communities, we are
creating a more just, equitable, and innovative healthcare delivery
system. Pay Range $80.17 - $119.26 /hour
Keywords: CommonSpirit Health, Denver , Physician Anesthesiology - Competitive Salary, Healthcare , Englewood, Colorado