- Intermountain Health (Harrisburg, PA)
- **Job Description:** Physician will provide Physician Advisor Utilization Reviewer and Central Appeals Work services. Physician shall engage, ... as an expert and local resource to hospital Case Management Department and Medical Staff on issues relating to... Utilization Review ("UR") Committee and provide Regional Physician Advisor Educators information to be shared… more
- Penn Medicine (Philadelphia, PA)
- …for assuring the effective and efficient utilization of health care services. The Physician Advisor is a physician serving the hospital through teaching, ... and utilization review departments and the hospital leadership. The Physician Advisor shall possess and/or develop expertise on matters regarding … more
- Highmark Health (Jefferson Hills, PA)
- **Company :** Allegheny Health Network **Job Description :** ESSENTIAL RESPONSIBILITIES: ** Physician Advisor - AHN** + Works in concert with the admitting ... denials and participates in data collection activities for resource utilization management . + Receives daily report form...regularly with coding and clinical documentation specialists. + The Physician Advisor would be an active member… more
- R1 RCM (Jenkintown, PA)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Physician Advisor ** , you will help our client facilities ... position. **Here's what you will experience working as a Physician Advisor :** + Addresses the following issues:...Serve as a clinical resource to medical and case management staff by providing identification, facilitation, and resolution of… more
- Trinity Health (Darby, PA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** The Appeals and Utilization Management Coordinator under direction and in collaboration with ... the RN Care Coordination Manager, provides support to the utilization management , denials and appeals process for...and processing the review to be conducted by the Physician Advisor to ensure all deadlines are… more
- Pennsylvania State University (Hershey, PA)
- …other resources to support an effective learning environment. + Oversees the utilization of the College's learning management system and other College/program ... applicants (https://hr.psu.edu/sites/hr/files/Application\_Process\_for\_External\_Applications\_Non-Penn\_State\_Employees\_.pdf) . JOB DESCRIPTION AND POSITION REQUIREMENTS: The Physician Assistant Director of Didactic Education and Master Educator… more
- UPMC (Harrisburg, PA)
- …requirements. + Takes leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor , Attending Physicians and clinical ... (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and… more
- Penn Medicine (Philadelphia, PA)
- …Oversees physician services cost analysis, focused on identifying and managing physician productivity. Facilitates open sharing of practice management and ... well as appropriate record documentation needs and techniques. Develops practice management profiles measuring physician productivity, compensation and incentive… more
- Penn Medicine (Philadelphia, PA)
- …and being a strong patient advocate.The case manager conducts utilization management activities, communication with insurers, team, and physician advisor ... appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor , with timely coordination of home care, DME,… more
- Highmark Health (Harrisburg, PA)
- …for denial trends with the care coordination teams, performance improvement teams, physicians/ physician advisor and third party payers. + Maintains a working ... knowledge of care management , care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.… more
- UPMC (Harrisburg, PA)
- …system. + Takes leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor , Attending Physicians and clinical team ... (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and… more
- UPMC (Harrisburg, PA)
- …requirements. + Takes leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor , Attending Physicians and clinical ... (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and… more
- UPMC (Harrisburg, PA)
- …requirements. + Takes leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor , Attending Physicians and clinical ... (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management , resource management , discharge planning and… more
- Fresenius Medical Center (Upper Darby, PA)
- …departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. + ... and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely… more
- Penn Medicine (Philadelphia, PA)
- …appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor , with timely coordination of home care, DME, ... hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management … more
- Penn Medicine (Philadelphia, PA)
- …patterns, and correlations. Leverage data to answer questions about market share, utilization , physician loyalty, payer types, and more. Identify potential ... Support** operates in targeted areas of Penn Medicine as a trusted advisor at the intersection of data analysis, business intelligence, and strategic consulting.… more
- Lancaster General Health (Lancaster, PA)
- …promoting cost-effective and quality healthcare services and managing the effective utilization of resources consistent with population health management ... to take appropriate corrective action as required. + Serves as business advisor to LG Health senior leadership regarding trends, issues and activities relevant… more
- Penn Medicine (Philadelphia, PA)
- …psychological, social and system issues of complex patients + .Support utilization management activities: communicate with insurers, interdisciplinary care team ... and Physician Advisor + .Lead discharge planning activities:...transportation + .Participate in quality data collection and risk management referrals + .The expected weekly caseload of the… more