- Intermountain Health (Boston, MA)
- **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
- Beth Israel Lahey Health (Plymouth, MA)
- …and identifies trends/root causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee as appropriate. ... Certification required + Minimum of 3 years of progressive experience in utilization management and appeal/denial management . + Holds a strong working… more
- Brockton Hospital (Brockton, MA)
- …denials, appeals and reconsideration hearings. Works closely with the physician advisor to proactively intervene in cases where utilization of resources is ... program that enhances the quality of patient care while optimizing resource utilization . Provides training to staff on case management methods and techniques.… more
- Beth Israel Lahey Health (Boston, MA)
- …discharge plan of care. Escalate deviations from the plan to the Physician Advisor as appropriate. Possesses effective verbal and written communication, ... quality indicators such as avoidable delays, length of stay, resource utilization , patient satisfaction, patient flow, outlier management , and readmissions… more
- Fresenius Medical Center (Fairhaven, MA)
- …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