• Physician Advisor Denials Management

    CommonSpirit Health (Sacramento, CA)
    …our hospitals and out in the community. **Responsibilities** **This is a remote position.** **Summary** The Utilization Management Physician Advisor II conducts ... Initiatives (CHI) and Dignity Health. With more than 700 care sites across the US from clinics and hospitals...and health information personnel + Conducts peer-to-peer reviews with payer medical directors to discuss and advocate for the… more
    CommonSpirit Health (09/20/24)
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  • System Physician Advisor , Safety & Quality…

    Novant Health (Winston Salem, NC)
    …goals and objectives for assuring the effective, efficient utilization of health care services. The Physician Advisor will have the responsibility of ... post discharge, care progression, denial management pertaining to post-acute care disposition, compliance with governmental and private payer regulations,… more
    Novant Health (09/28/24)
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  • Sr Strategic Advisor , Healthcare…

    BlueCross BlueShield of North Carolina (NC)
    …new forms of healthcare reimbursement, healthcare redesign consultation, payer /provider engagement and market offer opportunities. Leverages industry experience ... divisional operations, provider reimbursement, medical expense strategy and overall payer -provider dynamics. + Utilizes expertise to identify operational improvements… more
    BlueCross BlueShield of North Carolina (11/08/24)
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  • Director, Global Oncology Market Access

    Merck (Rahway, NJ)
    …will require a strong understanding of the oncology market, shifting global payer environment, and experience in market access, pricing, health outcomes, and launch ... individuals with strong US experience in access, value demonstration, and payer communications. This position will require outstanding cross functional leadership… more
    Merck (10/17/24)
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  • RN Care Coordinator - ECCM (Pittsburgh…

    Highmark Health (Harrisburg, PA)
    …Collaboratively formulates plans of action for denial trends with the care coordination teams, performance improvement teams, physicians/physician advisor and ... **Company :** Endorsed **Job Description :** **JOB SUMMARY** ** Remote /Hybrid - In home visits in and around...area.** This job is proficient in the coordination of care and manages coordination of care in… more
    Highmark Health (09/28/24)
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  • Care Coordinator, Utilization Management

    Hackensack Meridian Health (Neptune, NJ)
    …if required documentation is present. + Obtains appropriate records as required by payer agencies and initiates physician advisor 's review as necessary for ... and serve as a leader of positive change. The ** Care Management, Care Coordinator, Utilization Management** is...New Jersey regulations for Nursing **.** **This is a remote , night shift position. The schedule for this role… more
    Hackensack Meridian Health (08/16/24)
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  • RN Case Manager: University Hospital ( Care

    University of Michigan (Ann Arbor, MI)
    RN CASE MANAGER: University Hospital ( Care Management) Apply Now **Job Summary** The RN Case Manager assesses, develops, implements, coordinates and monitors a ... comprehensive plan of care for each patient/family in collaboration with the physician,...admission; review every 3 days or as requested by payer + Determine patient classification with provider and ensure… more
    University of Michigan (11/09/24)
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  • RN Charge Auditor

    Ascension Health (Glendale, WI)
    …education, experience, location, and qualifications. Connect with your Talent Advisor for additional specifics._ **Responsibilities** Coordinate payer denials ... some flexibility)** + **Hospital: AW Glendale Corporate Office** + **Location: Remote ** **RN License REQUIRED.** **Candidate MUST reside in Wisconsin.** **Benefits**… more
    Ascension Health (10/17/24)
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  • Manager Clinical Documentation Integrity

    Fairview Health Services (St. Paul, MN)
    …**Position Details:** + **Position:** Manager Clinical Documentation Integrity + **Location:** remote + **Employment Type:** Full-time (1.0 FTE, 80 hours per pay ... supports a compliant and accurate representation of the clinical care provided to the patients served. Is responsible for...appropriate + Leverages national data and remains current with payer trends needed to educate and lead teams to… more
    Fairview Health Services (10/29/24)
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  • Director Clinical and DRG Denials

    Kaleida Health (Buffalo, NY)
    …promotes a positive, team-oriented work environment. Develops relationships and influences payer policies and procedures as well as facilitating strong working ... relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments and leadership to promote effective… more
    Kaleida Health (08/26/24)
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  • Utilization Management Spec RN

    Fairview Health Services (St. Paul, MN)
    …scheduling includes fullt time days with weekend rotation. This is a remote role, orientation requires onsite availability. M Health Fairview offers a competitive ... necessary to secure reimbursement. This position assesses the patient's plan of care and progress of the patient throughout an acute care more
    Fairview Health Services (11/13/24)
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  • RN Case Manager- Case Management

    Health First (Viera, FL)
    …9. Works collaboratively and maintains active communication with physicians, nursing, physician advisor , and other members of the interdisciplinary care team to ... clinical skills in the assessment, planning, intervention and evaluation of patient care in accordance with Federal Conditions of Participation, State of Florida… more
    Health First (10/17/24)
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  • Lead Consultant, Claims and Market Data Analytics

    Penn Medicine (Philadelphia, PA)
    …is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field ... **Location: 3600 Civic Center Blvd.** **Hours: 8hr Days (Mostly Remote with some onsite requirements)** **Summary** : + **The...in targeted areas of Penn Medicine as a trusted advisor at the intersection of data analysis, business intelligence,… more
    Penn Medicine (09/05/24)
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  • Internal Audit Strategy & Technology Enablement…

    Robert Half (Houston, TX)
    …curious individuals for whom learning is a passion. We lean into our mission: We Care . We Collaborate. We Deliver. At every level, we champion leaders who live our ... complexities of the healthcare technology environment in healthcare provider , payer , pharmaceutical, and/or life sciences organizations. + Defining, designing,… more
    Robert Half (10/17/24)
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