- AdventHealth West FL Division (Tampa, FL)
- …staff office, medical school affiliation(s) and residency programs. The Associate CMO serves as physician advisor to the Case Management staff and serves as ... protocols that come with evidence based model approach. Provides counsel and physician perspective at senior leadership discussions and action plans related to… more
- CommonSpirit Health (Englewood, CO)
- **Job Summary and Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews ... patients and alternative levels of care. **The PA performs denials management and prevention in accordance with...required + **Minimum 3 years of experience as a Physician Advisor ** **managing denials required**… more
- UNC Health Care (Kinston, NC)
- …payor regulations. 3. Reviews all denials and works collaboratively with the Physician Advisor and Case management Assistants. 4. Reviews and documents ... gathers required clinical documentation and formulates appropriate appeals. Coordinates with the Physician Advisor and Case management Assistants in order… more
- Nuvance Health (Danbury, CT)
- …support inpatient level of care. If the case still does not meet, send to the Physician Advisor (PA) for a second level review. * Forward cases that require ... secondary physician review to appropriate resource (eg, Physician Advisor ). * Resolve any discrepancy at...appeals and communicating on a daily/regular basis with the Denials Management team. * Assists with informing… more
- Northwell Health (Melville, NY)
- …level of care and medical necessity for assigned case. + Collaborates with physician advisor , payor representative and site case managers to facilitate ... coding issues and knowledge gaps. Job Responsibility + Serves as liaison between the patient and facility/ physician and the third party payer. + Prepares and defends… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …patients, regulatory compliance, and utilization management (including LOS). 4. The Physician Advisor should discuss his/her role with the Hospital CMO, or ... We are seeking a physician with leadership experience interested in our new Physician Advisor position. 1. The Physician Advisor serves the… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Physician Advisor position is responsible for teaching, consulting, and advising the case management department, clinical ... of healthcare quality and acceptable levels of cost. The Physician Advisor position will conduct clinical reviews...team, in order to assist with the identification and management of denials . Make suggestions related to… more
- Nuvance Health (Danbury, CT)
- …procedure and approach to physician advisor roles in utilization management , , documentation and denials /downgrades. * Serves as physician expert ... the organization. * Manages processes, policies, workflows and overall management of the physician advisor ...all levels of care) * Understanding of approaches to denials management * Familiarity with clinical documentation… more
- Penn Medicine (Philadelphia, PA)
- …Monument Road, Bala Cynwyd, PA Hours: M-F, 8hr days, hybrid Summary: + The CDI Physician Advisor is a key member of the healthcare organization's leadership team ... (approximately 80%) with a clinical component (approximately 20%).The CDI Physician Advisor will act as a resource...staff, and all areas of clinical documentation improvement, CEQI, denials management , coding, utilization management … more
- Penn Medicine (Philadelphia, PA)
- …Our employees shape our future each day. Are you living your life's work? The Physician Advisor is a key member of the healthcare organization's leadership team ... effective and efficient utilization of health care services. The Physician Advisor is a physician ...on cases placed in Observation * Participate in the denials management process * Be a leader… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on ... of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance… more
- CommonSpirit Health (Salt Lake City, UT)
- …must be located in or willing to relocate to the Salt Lake City Area._ The Physician Advisor reports directly to the Medical Director Physician Advisor ... partnership with the Medical Director CDI, Enterprise Director Case Management , UM Hub Director, and Care Coordination Leaders at...Committees or administrative roles, preferred. + Experience as a Physician Advisor in the acute care setting… more
- Ascension Health (Austin, TX)
- **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Remote (with some on-site prescense ... Highlights** Ascension in Austin, TX is looking for a Physician Advisor to join our team. We...setting (Adult Medicine Hospitialist experience preferred), preferably with some Physician Advisory/ Utilization Management work experience. If… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Hybrid (frequently on site) + **Call ... **Position Highlights** Ascension St. Vincent is looking for a Physician Advisor to join our team. We...work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If… more
- Hackensack Meridian Health (Neptune City, NJ)
- ** Physician Advisor at Jersey Shore University Medical Center** NEPTUNE CITY, NJ - Jersey Shore University Medical Center, a leading academic medical center and ... to join our team in the vital role of Physician Advisor . This unique opportunity allows you...closely with the Chief Medical Officer and the Care Management Department to ensure the delivery of efficient and… more
- Trinity Health (Des Moines, IA)
- … with Inpatient experience for a newly opened but established role as a Physician Advisor . The ideal candidate will have served on Hospital committees or ... working knowledge of CMS and commercial insurance regulations. The Physician Advisor must possess a team-building mindset...health plan, and clinical guidelines in the review of denials . Serve as a resource for physicians regarding… more
- Nuvance Health (Danbury, CT)
- …and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social work, and non-clinical ... of care, prevent readmissions, and optimize patient outcomes. * * Denials Management & Appeals:* * *Root Cause...efforts, and negotiate with payers for fair reimbursement. * * Physician Advisor Collaboration:* Collaborate with the … more
- Brockton Hospital (Brockton, MA)
- …review, denials , appeals and reconsideration hearings. Works closely with the physician advisor to proactively intervene in cases where utilization of ... PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management Program for… more
- Houston Methodist (Houston, TX)
- …review teams to facilitate efficient use of resources and seeks assistance from the Physician Advisor when necessary. Informs management of the possible need ... utilization review functions through point of entry, observation progression of care management , concurrent review and denials reviews. Additionally, the URSN… more
- Tenet Healthcare (Detroit, MI)
- …status and level of care per Tenet policy. Oversees submission of cases to Physician Advisor review to ensure timely referral, follow up and documentation. ... Crimson data to provide timely and meaningful information to the Utilization Management Committee and physician staff for performance improvement. * Monitors… more
