- Novo Nordisk Inc. (Walnut Creek, CA)
- …productively and respectably challenge and influence target physicians' approach to patient management and adds value by sharing new information and unique insights ... Leverages superior understanding of complexities within the targeted physician customer base in order to maximize performance Applies high level business acumen and… more
- Merck & Co. (Rahway, NJ)
- …to characterize disease burden and epidemiology, treatment patterns, healthcare resource utilization and costs, physician and patient satisfaction surveys, ... presentations, and publicationsResponsible for study-related contracting, budgets, and vendor/partner management , and to ensure study conduct is aligned with company… more
- Merck & Co. (North Wales, PA)
- …to characterize disease burden and epidemiology, treatment patterns, health-care resource utilization and costs, physician and patient satisfaction surveys, ... presentations, and publications.Responsible for study-related contracting, budgets, and vendor/partner management and ensures study conduct is aligned with company… more
- Sutter Health (Sacramento, CA)
- …Advisor will work closely with the medical staff, including house staff, and all utilization management (UM) personnel, Care Management (CM) personnel to ... health care services. The PA will develop expertise on matters regarding physician practice patterns, over- and under- utilization of resources, medical… more
- CommonSpirit Health (Englewood, CO)
- **Responsibilities** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews referred by case management staff and/or other ... team, medical staff, and medical executives to encourage physician cooperation and understanding of documentation importance + Assists...such as Joint Operating Committee (JOC), as requested by Utilization Management or Care Management .… more
- CommonSpirit Health (Houston, TX)
- …a remote position and you must be licensed in the state of Texas. As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews ... care services. The PA communicates remotely with case and utilization management to discuss selected cases and...+ Minimum of 1 year of experience as a Physician Advisor preferred. + Minimum of 5 years of… more
- Penn State Health (Hershey, PA)
- …performing the processes. The incumbent is responsible for identifying and communicating utilization management concerns to physician and administrative ... **SUMMARY OF POSITION:** Position is responsible to thoroughly understand all Utilization Management regulatory requirements for both CMS and DOH,… more
- Covenant Health Inc. (Knoxville, TN)
- …Operations Coordinator will perform activities to help facilitate utilization management functions related to the coordination of physician advisor related ... to denials. + Maintains a monthly data report on each physician 's activities impacting Utilization Management activities. + Manages physician advisor… more
- UPMC (Pittsburgh, PA)
- The Medical Director, Utilization Management is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC ... Changing Medicine happen. **Responsibilities:** + Actively participates in the daily utilization management and quality improvement review processes, including… more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …Experience supervising physicians and supporting utilization management as a Physician Utilization Management Advisor (PUMA) is preferred; Must be ... L. Pettis Memorial Veterans Hospital is recruiting for a Full-Time, Permanent, Physician , Chief of Inpatient Medicine and reports directly to the ED-Inpatient… more
- Veterans Affairs, Veterans Health Administration (West Palm Beach, FL)
- …(HRO), performs psychiatry Quality of Care audits and functions as the Department Physician Utilization Management Advisor (PUMA) to ensure compliance. ... of mental health. Incumbent collaborates and participates with facility leadership and Utilization Management to ensure practices follow JC, CARF, and CO… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …and Medical Management clinical staff, including Care Management , Utilization Management , and the Physician Review Unit.The Operational Support ... supporting clinical operations including the Physician Review Unit, Case Management and Utilization Management . Some of the tasks the operational support… more
- Nuvance Health (Danbury, CT)
- …rotate one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician , the interdisciplinary team, and ... of care and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level medical necessity reviews… more
- Ascension Health (Jacksonville, FL)
- …5 years of recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If you are ready ... **Details** + **Department** : Case Management + **Schedule:** Full Time | Hybrid (frequently...**Position Highlights** Ascension St. Vincent is looking for a Physician Advisor to join our team. We are looking… more
- Ascension Health (Hoffman Estates, IL)
- …years of recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. This position reports ... Time | Onsite + **Practice Details:** Join experienced Case Management Team + **EMR** **System:** Cerner + **Facility** :...**Position Highlights** Ascension St. Alexius is looking for a Physician Advisor to join our team. We are looking… more
- Catholic Health Services (Melville, NY)
- …clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required. Communicates ... changes from the Managed Care Department and applies to UM and appeals management processes. Works collaboratively with physicians, physician office staff and… more
- Catholic Health Services (Melville, NY)
- … Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. Supervises the Facility Physician ... develops standard system-wide implementation plans and policies. Works with system Care Management (CM) leadership and Catholic Health Physician Advisors (as… more
- Parkview Health (Fort Wayne, IN)
- …least two years of comprehensive experience in managed healthcare, provider relations, utilization management or physician office experience Other ... Summary Responsible for the maintenance and management of provider contracts for Health Plan Services (HPS). Investigates and resolves concerns from providers,… more
- Boulder Community Hospital (Boulder, CO)
- …BCH services as well as reporting utilization trends to management . *Travels to targeted physician offices/practices throughout primary and secondary ... independent. Working closely with the Chief Business Officer and other key management personnel, the Physician Liaison assists in establishing and communicating… more
- ChenMed (Miami, FL)
- …people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management /Clinical Appropriateness review cases in our ... Process and Quality improvement in our developing area of Delegated Utilization Management . **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Provides Delegated… more
