- 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
- 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
- Virginia Mason Franciscan Health (Burien, 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. This position will work with our St. Anne Hospital in… more
- Carle Health (Champaign, IL)
- … and clinical denials management . + The Behavioral Health Physician Advisor is also expected to onboard the new providers regarding utilization ... with our Utilization Management RN team, Clinical Denials Management team and the Physician Advisor Team which is comprised of five other physicians.… 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
- Northwell Health (Melville, NY)
- …defends level of care and medical necessity for assigned case. Collaborates with physician advisor , payor representative and site case managers to facilitate ... Review standard and regulations. Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts clinical reviews… 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 MGMT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level ... of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance… more
- Ascension Health (Georgetown, 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
- 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
- Hackensack Meridian Health (North Bergen, NJ)
- Hackensack Meridian _Health_ is seeking a collaborative Physician Advisor to join our growing health network. This is an excellent opportunity to become a key ... closely with the Chief Medical Officer and the Care Management Department to ensure the delivery of efficient and...and effective healthcare. This role is perfect for a physician leader passionate about shaping healthcare systems and driving… more
- Hackensack Meridian Health (Neptune City, NJ)
- …and experienced physician to join our team in the vital role of Physician Advisor . This unique opportunity allows you to leverage your clinical expertise and ... closely with the Chief Medical Officer and the Care Management Department to ensure the delivery of efficient and...and effective healthcare. This role is perfect for a physician leader passionate about shaping healthcare systems and driving… more
- AdventHealth (Orlando, FL)
- …of accurate, thorough documentation. Participate in mortality reviews, DRG downgrade denials management , and clinical validation processes. Compliance and ... the severity of illness, risk of mortality, and complexity of care Physician and Staff Education: Educate physicians and advanced practice providers (APPs) on… 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
- 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