- Prisma Health (Maryville, TN)
- …of care and timely implementation of plan of care in accordance with hospital(s) Utilization Review Plan and CMS regulation. Maintains expert level knowledge of ... the regulatory documents as provided by CMS. Consults with interdisciplinary team, Physician Advisor and administrative leadership as necessary to resolve… more
- Beth Israel Lahey Health (Plymouth, MA)
- …trends/root causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee as appropriate. + Participate ... you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We Are:** At… more
- CareFirst (Baltimore, MD)
- …+ Experience in utilization management or served as physician advisor for utilization review in healthcare entities. Previous experience working ... **Resp & Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review , care management and quality to determine the medical… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …and identification of trends in the over and under- utilization of resources. 2. The Physician Advisor should be a key member of the medical staff and take on ... the role as leader of the Hospital's utilization review /management committee, which is charged with...and utilization management (including LOS). 4. The Physician Advisor should discuss his/her role with… more
- Nuvance Health (Danbury, CT)
- …the organization. * Works to lead standardization of policy, procedure and approach to physician advisor roles in utilization management, , documentation and ... of hospitalization, LOC status, LOS management, continued stay decisions, clinical review of patients, utilization review activities, resource… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Physician Advisor position is responsible for teaching, consulting, and advising the case management department, clinical documentation ... is a key member and leader of the hospital's utilization review /management committee, which is charged with...of healthcare quality and acceptable levels of cost. The Physician Advisor position will conduct clinical reviews… more
- HonorHealth (AZ)
- …staff regarding federal and state utilization and quality regulations. As a CDI physician advisor , the PA will act as a liaison between the CDI ... Learn more at HonorHealth.com. Responsibilities Job Summary The System Physician Advisor (PA) serves as a liaison...reviewing a particular patient record. Assists with identifying a physician to review such record. Acts as… more
- Mohawk Valley Health System (Utica, NY)
- …level of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure ... hospitals objectives, and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides the… more
- AdventHealth (Orlando, FL)
- …for our contracted managed care payers. The PA role is responsible for providing physician review of utilization , claims management, and quality assurance ... inpatients and 125,000 outpatients each year **The role you'll contribute:** As the physician advisor (PA), this role educates, informs, and advises members of… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our...Medi-Cal reimbursement. + Analyzes cases for referral to the physician advisor to ensure that the admission… more
- Sutter Health (Oakland, CA)
- …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Bay **Position Overview:** The Physician Advisor (PA) is a key member of the hospital's ... to appropriately optimize the use of Sutter Health Internal Physician Advisor Services (IPAS). The physician...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- Atlantic Health System (Summit, NJ)
- …from ABQAURP (The American Board of Quality Assurance and Utilization Review Physicians), AAPL (American Association for Physician Leadership's Physician ... in Management course), or CPUR (Certification Program in Utilization Review ), Institute for Healthcare Improvement courses, or physician advisor training… more
- CommonSpirit Health (Englewood, CO)
- **Job Summary and Responsibilities** **This is a remote position** As the Utilization Management Physician Advisor (PA), the PA conducts clinical case ... providing quality patient care, to assure effective and efficient utilization of health care services. The PA communicates remotely...+ Minimum of 1 year of experience as a Physician Advisor preferred. + Minimum of 5… more
- Ascension Health (Austin, TX)
- **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Remote (with some on-site prescense required) + ... Highlights** Ascension in Austin, TX is looking for a Physician Advisor to join our team. We...setting (Adult Medicine Hospitialist experience preferred), preferably with some Physician Advisory/ Utilization Management work experience. If… more
- CommonSpirit Health (Englewood, CO)
- **Job Summary and Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews ... the submission of necessary documentation. + Assists in communications of internal physician advisor services in the hospital newsletters and other communication… more
- CommonSpirit Health (Salt Lake City, UT)
- …must be located in or willing to relocate to the Salt Lake City Area._ The Physician Advisor reports directly to the Medical Director Physician Advisor ... Staff and Hospital Committees or administrative roles, preferred. + Experience as a Physician Advisor in the acute care setting and/or the payer environment,… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Hybrid (frequently on site) + **Call Schedule:** ... **Position Highlights** Ascension St. Vincent is looking for a Physician Advisor to join our team. We...work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If… more
- Hackensack Meridian Health (Neptune City, NJ)
- …a highly motivated and experienced physician to join our team as a ** Physician Advisor ** . This vital role offers a unique opportunity to combine your ... outcomes. + Board Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. + Membership in the American… more
- MaineGeneral Health (Augusta, ME)
- …is seeking an experienced physician , (MD or DO) for the role of Physician Advisor . In this role, the individual will: + Provide clinical leadership and ... and resource overutilization. + Lead or actively participate in the Utilization Review Committee, ensuring compliance with regulatory requirements, reviewing… more
- Trinity Health (Des Moines, IA)
- … with Inpatient experience for a newly opened but established role as a Physician Advisor . The ideal candidate will have served on Hospital committees or ... working knowledge of CMS and commercial insurance regulations. The Physician Advisor must possess a team-building mindset...a 403B match. **Essential Job Details** : . Lead physician -driven clinical resource utilization program, and work… more
