- Dignity Health (Carmichael, CA)
- …a Certificate of Excellence for Hip and Knee Replacements. **Responsibilities** The Physician Advisor plays a critical role in promoting evidence-based standards ... practice, regulatory and quality considerations in the delivery of medical care. The Physician Advisor plays a key role in the following: advocating for the best… more
- Dignity Health (San Bernardino, CA)
- …Wellness Program. + Paid Time Off (PTO). **Responsibilities** **Position Summary:** As our Physician Advisor you will play a critical role in promoting ... metrics adopted by Hospital. **Qualifications** **Required Licensure:** + Must be a licensed Physician (MD or DO) in the state of California. \#LI-DH **Pay Range**… more
- Sharp HealthCare (San Diego, CA)
- …This position ensures timely and proactive interaction with the CPPC team, admitting/attending physician , payer, physician advisor and other members of the ... system emergency departments (ED), attending physicians as well as the physician advisor . Assists in the repatriation and post-stabilization process to mitigate… more
- Sharp HealthCare (San Diego, CA)
- …reconciliation. This position ensures timely and proactive interaction with the admitting/attending physician , payer, physician advisor and other members of ... with system emergency departments (ED), attending physicians as well as the physician advisor .Identifies and escalates cases not meeting criteria for admission… more
- Alameda Health System (San Leandro, CA)
- …Interqual(R) clinical guidelines; refers questionable cases to the CM Manager or physician advisor for determination. 3. Collaborates and communicates regularly ... denials with the attending physician and the Care Management physician advisor ; prepares case reports; documents treatment plan, progress notes and discharge… more
- Alameda Health System (Oakland, CA)
- …Interqual(R) clinical guidelines; refers questionable cases to the CM Manager or physician advisor for determination. 3. Takes appropriate action when cases ... Escalates to the attending physician , and the Care Management physician advisor of any concurrent denials.Prepares case reports;documents treatment plan,… more
- The County of Los Angeles (Los Angeles, CA)
- …and analyzes reports prepared by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of physician advisor ... Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the Utilization Review Committee, the incumbent is responsible… more
- LA Care Health Plan (Los Angeles, CA)
- …and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and ... High risk/high cost cases and reports are maintained and referred to the Physician Advisor /UM Director. Document in platform/system of record. Utilize designated… more
- Sedgwick (West Hills, CA)
- …and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability ... disability plan. + Reviews and analyzes complex medical information (ie attending physician statements, office notes, operative reports, etc.) to determine if the… more
- CVS Health (Sacramento, CA)
- …managed care, as a provider and manager of care utilization review or physician advisor experience. *Child/Adolescent Board Cert **Education** * Active and ... efficiency involving clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including the management of… more
- Alameda Health System (San Leandro, CA)
- …action when cases do not meet criteria - coordinates denials with the attending physician , and the UR physician advisor . Prepares case reports; documents ... disposition of Medi-Cal, self-pay, and out-of-plan patients, including working with physician to determine readiness for transfer, securing placement and completing… more
- Alameda Health System (Alameda, CA)
- …action when cases do not meet criteria - coordinates denials with the attending physician , and the UR physician advisor . Prepares case reports; documents ... disposition of Medi-Cal, self-pay, and out-of-plan patients, including working with physician to determine readiness for transfer, securing placement and completing… more
- Providence (Santa Monica, CA)
- …other Directors to ensure appropriate utilization. + Refers appropriate cases to the Physician Advisor where there are concerns or questions regarding treatment, ... of performance on a timely basis. + Responds to customer (patient and physician ) concerns in a responsive, timely, and respectful manner. Thoroughly reviews system… more
- Sharp HealthCare (La Mesa, CA)
- …utilization management venues.Escalate and refers cases for consultation with Physician Advisor or Medical Director as appropriate.Oversee preparation, ... a comprehensive plan of care for each patient/family in collaboration with the physician , social worker and all members of the interdisciplinary team in the… more
- Travelers Insurance Company (Irvine, CA)
- …+ Engage specialty resources as needed to achieve optimal resolution (Dial-a-doc, physician advisor , peer reviews, MCU). + Partner with Claim Professional ... to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome. + Utilize internal Claim Platform Systems to manage all claim activities on a timely basis. + Utilize Preferred Provider Network per… more
- Evolent (Sacramento, CA)
- … Advisor will be primarily responsible for primary care physician IPA (Individual Practice Association and/or MSO (Management Services Organization) engagement ... connected care journey. We are hiring for a Senior Practice Performance Advisor to join our Provider Relations Team. **Collaboration Opportunities:** The Senior… more
- CenterWell (San Diego, CA)
- …our caring community and help us put health first** The Clinical Assessment Advisor directly completes and oversees development/ of the plan of treatment as approved ... by physician , performs ongoing evaluation of patient needs and coordinates...health aides to ensure optimal clinical outcomes. Works with physician and/or referral source to obtain all pertinent clinical… more
- Cardinal Health (Sacramento, CA)
- …literature requests) and tradeshow coordination. **_Job Summary_** The Sr. Advisor , Event Marketing Operations is responsible for the planning, coordination ... sponsored and sales-led tradeshows across Biopharma Solutions and Specialty Physician Practices businesses within the Cardinal Health Pharmaceutical & Specialty… more
- Insight Global (Rancho Cordova, CA)
- …Requirements - extensive advisory experience on emerging technologies in healthcare - physician or clinical background null We are a company committed to creating ... diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for… more
- Vighter Medical Group (Imperial, CA)
- Regional Physician Supervisor (MD), El Centro, CA Job Details Job Location El Centro, CA BPA - Imperial, CA Position Type 1099 Education Level Doctorate (DO or MD) ... Job Shift Any Job Category Health Care Description Title:Regional Physician Supervisor Location:El Paso, TX; Laredo; Rio Grande Valley,...pediatric care in the absence of a behavioral health advisor or pediatric advisor . + Clinical supervisory… more