- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Physician Advisor ** , you will help our client facilities ... in this remote position. **Here's what you will experience working as a Physician Advisor :** + Addresses the following issues: compliance and level of care. +… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Physician Advisor ** , you will help our client facilities ... this remote position. **Here's what you will experience working as a Physician Advisor :** + Addresses the following issues: authorization requested,… more
- Henry Ford Health System (Detroit, MI)
- …. + Previous experience as Director of Utilization Review or Physician Advisor preferred. CERTIFICATIONS/LICENSURES REQUIRED: + Michigan Medical license ... a timely manner 9. Code 44s - UM committee physician concurrent statement. CMS Conditions of Participation 10. Lead...cases b. Complete P2P for those payors that allow physician advisors to complete a P2P 12. Educate … more
- Sedgwick (Southfield, MI)
- …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
- Tenet Healthcare (Detroit, MI)
- …the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning ... of care based on Medical Necessity process and submits case for Secondary Physician review per Tenet policy. Ensures timely communication of clinical data to payers… more
- Tenet Healthcare (Detroit, MI)
- …appropriate patient status and level of care Oversees submission of cases to Physician Advisor to ensure timely referral, follow up and documentation Monitors ... Recognizes and responds to medical emergencies as appropriate. Provides physician -prescribed post care instructions to patients. Participates in process improvement… more
- Tenet Healthcare (Detroit, MI)
- …inappropriate utilization of resources or quality issues to management and to a physician advisor . Identifies non-acute days or delays in discharge and assesses ... causative factors. Establishes and maintains effective relationships with physicians and all other staff members, internally and externally. Identifies problems or any dissatisfaction experienced by any customer or referring source and works to resolve them to… more
- Tenet Healthcare (Detroit, MI)
- …responsibility. As directed, implements external and internal audit recommendations. Engages physician advisor to facilitate care decisions, as needed. Maintains ... current knowledge of health care techniques/practices, and case management strategies through educational programs/resources. Maintains a working knowledge of the requirements of payers, regulatory and compliance entities. Establishes and maintains effective… more
- Trinity Health (Pontiac, MI)
- …Refers all cases lacking IS/SI criteria for acute care hospitalization to the Physician Advisor or designee according to the established department guidelines. 3 ... Collaborates with Case Management on identifying those patients not meeting the acute care criteria and works with case manager to gather additional clinical information for reimbursement. 4 Provides consultation and information to physicians, case management… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- …Malpractice: Free liability protection with tail coverage provided Contract: No Physician Employment Contract and no significant restriction on moonlighting The ... to determine fitness-for-duty. May order a psychiatric and psychological assessment. The physician shall complete a medical report for all OWCP cases treated in… more
- Corewell Health (Grosse Pointe, MI)
- …and documents on EPIC. Communicate with patients and physician /office regarding authorization/referral requirements. Obtain financial responsibility forms or ... EPIC tools. Provide information for follow up and referral to the Financial Advisor as appropriate. Initiate payment plans and obtain payment, Informs and explains… more
- City of Detroit (Detroit, MI)
- …department which functions present specialized legal problems; and/or serves as legal advisor and counsel for the City of Detroit agencies, officials and personnel ... plan. You will have to choose a primary care physician that serves within the PCP Focus network. This...serves within the PCP Focus network. This primary care physician coordinates your care. The network includes over 22,000… more