• Quality Officer III ( Medicare )

    RWJBarnabas Health (Oceanport, NJ)
    Quality Officer III ( Medicare )Req #:0000183242 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:HIM - Coding ... integrity of ICD-10-CM/PCS coding and DRG assignment for inpatient Medicare encounters. This requires critical thinking and a higher...a team with other Quality Officers to ensure SMART review goals are met for all RWJBarnabas facilities. +… more
    RWJBarnabas Health (01/10/25)
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  • Senior Medicare Coverage Analyst

    Dana-Farber Cancer Institute (Brookline, MA)
    The Medicare Coverage Analyst (MCA) is responsible for reviewing clinical research protocols, Informed Consent Forms, Clinical Trial Agreements, and other relevant ... insurance and which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies are a Qualifying… more
    Dana-Farber Cancer Institute (12/17/24)
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  • Medicare Biller

    Insight Global (Cincinnati, OH)
    Job Description Insight Global is looking for a Medicare Biller for a contract to hire opportunity in the Blue Ash area of Cincinnati. This person will be joining a ... claims for a large health system (both in patient hospital and out patient physician claims). This person will be primarily responsible for medicare billing,… more
    Insight Global (12/31/24)
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  • VP, Phco Utilization Management - Medicare

    Centene Corporation (Tallahassee, FL)
    …Purpose:** Oversee operations of the referral management, telephonic utilization review , prior authorization, and various related functions across multiple ... Medicare & Duals product lines at the enterprise level....Oversee the operations of utilization management, reconciliation coordination, concurrent review (telephonic and on-site), specialty therapy programs and other… more
    Centene Corporation (01/26/25)
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  • Physician Utilization Review

    Hackensack Meridian Health (Hackensack, NJ)
    **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity ... and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and transitions of care,… more
    Hackensack Meridian Health (11/18/24)
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  • Physician Advisor - Utilization Management

    Ochsner Health (New Orleans, LA)
    …Board Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) or (3) Physician Advisor Sub-Specialty Certification ... make a difference at Ochsner Health and discover your future today!** The Physician Advisor (PA-Utilization Management) serves as the physician leader in matters… more
    Ochsner Health (01/29/25)
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  • Registered Nurse Case Manager-Child and Adolescent…

    Hackensack Meridian Health (Maywood, NJ)
    …to assess needs and develop an individualized plan in collaboration with the physician and other members of the health care team. + Facilitates communication and ... available health care benefits, and Provides Second Important message is provided to Medicare patients 4 to 48 hours prior to discharge. + Participates actively on… more
    Hackensack Meridian Health (01/03/25)
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  • Primary Care Physician

    CenterWell (Garland, TX)
    …part of our caring community and help us put health first** The Physician focuses on outpatient medicine, continuity of care, health maintenance, and disease ... positive and welcoming environment for all. The Primary Care Physician (PCP) works as a lead in our team-based...Clinical Leadership. Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.… more
    CenterWell (12/20/24)
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  • Hospice Physician , Medical Director, Part…

    BAYADA Home Health Care (Tucson, AZ)
    BAYADA Hospice is immediately seeking a **part time Hospice Physician -Medical Director** to join our Tucson, Arizona Hospice team. BAYADA Hospice provides the ... quality of life. We are currently hiring a **part time Hospice Physician -Medical Director** to join our team of dedicated, compassionate caregivers to collaborate… more
    BAYADA Home Health Care (01/29/25)
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  • Lead Physician Advisor

    Trinity Health (Silver Spring, MD)
    **Employment Type:** Full time **Shift:** **Description:** **Position Title: Lead Physician Advisor** **Employment Type: Exempt** **What We Offer:** Competitive ... distance from Washington DC and Baltimore, MD **General Summary:** Provides physician leadership and expertise related to appropriate utilization/level of care… more
    Trinity Health (02/01/25)
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  • Associate Chair of Oncology - Physician

    Mount Sinai Health System (NJ)
    …with their job descriptions and the VMG Compact + Participate in the annual physician performance review process in Oncology Services + **Engage in the ... Health System mean our doctors collaborate with the top physician leaders in medicine today. The Valley Hospital is...medical group governance, quality assurance, risk management and peer review .** + Advocate on behalf of VMG Oncology Services… more
    Mount Sinai Health System (01/21/25)
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  • Coord Physician Advsr Ops

    Covenant Health Inc. (Knoxville, TN)
    Overview Physician Advisor Operations Coordinator, Revenue Integrity and Utilization PRN/OCC, Variable Hours, Day Shift Covenant Health Overview: Covenant Health is ... and Covenant Medical Group (http://www.covenantmedicalgroup.org/) , our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is… more
    Covenant Health Inc. (02/01/25)
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  • Physician Advisor - Director (Facility)

    Catholic Health Services (Melville, NY)
    …hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the ... Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical documentation. Works… more
    Catholic Health Services (11/14/24)
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  • Physician Reviewer BH PRU, Part Time

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …tasks as assigned by the Associate Medical Director of the Physician Psychologist Review Unit + Adhere to NCQA, URAC, Medicare and other regulatory standards ... At the request of the Associate Medical Director of the Physician Psychologist Review Unit, the Reviewer also provides clinical leadership in other areas… more
    Blue Cross Blue Shield of Massachusetts (01/11/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance ... PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The...of admission and continued stay, severity, and morbidity/mortality. + Review patient status when admission criteria is non-sufficient for… more
    Mohawk Valley Health System (12/18/24)
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  • Physician (MD, Do) - Primary Care

    CareOregon (Portland, OR)
    …care costs and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to our patients, ... diseases. This trend will continue as roughly 10,000 baby boomers a day enter the Medicare system. If you receive an offer of employment for this position, it is… more
    CareOregon (01/09/25)
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  • Physician Advisor

    Trinity Health (Silver Spring, MD)
    **Employment Type:** Full time **Shift:** **Description:** **Position Title:** Physician Advisor **Type of Position:** Exempt **What We Offer:** Benefits, Free ... distance from Washington, DC, and Baltimore, MD. **Position Overview:** The Physician Advisor provides expertise related to appropriate utilization/level of care… more
    Trinity Health (01/17/25)
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  • Per-Diem Hospice Physician Virtua

    Virtua Health (Marlton, NJ)
    …than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, ... Total Weekly Hours: 0 Additional Locations: Job Information: Job Summary: The Physician Hospice is responsible for providing clinical leadership and expertise to the… more
    Virtua Health (12/18/24)
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  • Clinical Physician 1 or 2 (Hourly - Bronx…

    New York State Civil Service (Bronx, NY)
    NY HELP No Agency Addiction Services and Supports, Office of Title Clinical Physician 1 or 2 (Hourly - Bronx Addiction Treatment Center) Occupational Category Health ... Serve as health advisor to multi-disciplinary team; provide consultation/peer review to other physicians/clinicians; supervise nurse practitioner; actively participates… more
    New York State Civil Service (01/23/25)
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  • Physician Assistant (NY Helps)

    New York State Civil Service (Tupper Lake, NY)
    …HELP Yes Agency People With Developmental Disabilities, Office for Title Physician Assistant (NY HELPS) Occupational Category Health Care, Human/Social Services ... care andservices under the direct supervision of a licensed physician . Typical duties will include:* Caring for the acute...- in a residential setting* Works with psychiatrist to review his consultations of patients with treatment team. Provides… more
    New York State Civil Service (12/20/24)
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