- Elevance Health (Hickory, NC)
- \#HealthyBlueCareTogetherCFSP ** Clinical Care Advisor - Complex Medical** **$3,500 SIGN ON BONUS** _We are partnering with North Carolina DHHS to ... unless an accommodation is granted as required by law. The ** Clinical Care Advisor - Complex Medical** is responsible for the Children and Families… more
- Elevance Health (Asheville, NC)
- HealthyBlueCareTogetherCFSP ** Clinical Care Advisor - Behavioral Health (BH) and BH Crisis** **$2,500 SIGN ON BONUS** _We are partnering with North Carolina ... an accommodation is granted as required by law. The ** Clinical Care Advisor - Behavioral...is responsible for coordinating operations and workflows related to complex medical case management activities in support of CFSP… more
- The Cigna Group (St. Louis, MO)
- …Advisor /Program Management Advisor provides insight and guidance on complex clinical rebate modeling assignments/projects and provide financial rebate ... in an optimal formulary consulting service model. Serves as clinical advisor resource providing ongoing product and...a plus + 2+ years of pharmacy/ PBM/ Managed Care /healthcare related experience + 1+ years of formulary management/development… more
- The Cigna Group (Austin, TX)
- …sales, clinical product and program teams, marketing, data and analytics, clinical operations, health engagement, Evernorth Workplace Care and others, to ... the health, well-being and sense of security for those we serve. The Clinical Sales and Network Organization, as Champions for affordable, predictable and simple… more
- The Cigna Group (Portland, OR)
- …withsales, clinical product and program teams, marketing, data and analytics, clinical operations, health engagement, Evernorth Workplace Care and others, to ... Network Organization, as Champions for affordable, predictable and simple health care , is dedicated to achievement of our Enterprise goals improving affordability… more
- The Cigna Group (Bloomfield, CT)
- **POSITION SUMMARY** The Senior Clinical Consultant, Academic Detailing will support quality, safety, and trend initiatives within the Express Scripts Provider ... trends, claims data, and medication regimens to find financial and clinical intervention opportunities, communication with providers, and collaboration with the… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …to providers and appropriate department chairs as necessary * Provide consultation to Care Coordination staff regarding complex clinical issues and advises ... the cost of care . 3. The Physician Advisor will conduct clinical reviews on cases...Our dedicated providers offer a full spectrum of health care services, from routine wellness to complex … more
- WelbeHealth (Los Angeles, CA)
- …seniors with better quality and compassion in a value-based model. The Senior Care Advisor helps assess PACE eligibility by fostering relationships with ... and their caregivers. A trusted telephonic resource, the Senior Care Advisor helps guide seniors who may...applicable. + Collaborate closely with market leaders and the clinical team to move prospective participants through the enrollment… more
- Penn Medicine (Philadelphia, PA)
- …care provided. This role is primarily administrative (approximately 80%) with a clinical component (approximately 20%).The CDI Physician Advisor will act as a ... our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future...of providing the best experience for our patients and clinical teams. The CDI Physician Advisor should… more
- Guidehouse (Mclean, VA)
- …market research and technical evaluation panels. You'll also advise on clinical , regulatory, and manufacturing aspects of medical product development, ensuring ... and lifecycle cost strategies. As a program and technical advisor , you will be a critical member of project...critical member of project teams, helping our clients solve complex public health and business challenges from strategy through… more
- Mohawk Valley Health System (Utica, NY)
- …GMLOS + Partner with the care management team with the management of LOS, complex care needs and patient throughput efforts. Provide transition of care ... ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending...status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases… more
- Nuvance Health (Danbury, CT)
- …Provides physician leadership and expertise related to appropriate utilization/level of care (LOC) and appropriate clinical documentation. Provides oversight for ... (attending) physicians. * ;Assists Denial Prevention and Denial Management teams with complex cases requiring Physician Advisor expertise to support both peer… more
- Houston Methodist (Houston, TX)
- …alternative levels of care . Provide consultation to case management staff regarding complex clinical issues and advises on next steps. Provide feedback to ... ensuring high levels of healthcare quality and acceptable levels of cost. The Physician Advisor position will conduct clinical reviews on cases referred by case… more
- Sanford Health (SD)
- …grow as team member with educational opportunities. **Job Summary** The Improvement Advisor works with leadership to organize, assist, and coordinate planning and ... of systematic, organization-wide approaches to improving outcomes. The Improvement Advisor will support corporate and local strategic plans that achieve… more
- UCLA Health (Los Angeles, CA)
- Description The Physician Advisor provides physician leadership and clinical expertise related to coordination of patient care , length of stay and level of ... variation management, patient flow/throughput management, ancillary services utilization and clinical documentation improvement. The Physician Advisor reviews … more
- R1 RCM (Boise, ID)
- …or lack of support for that authorization, evidence-based criteria for that support, and complex clinical evaluation of the request as a whole. + Review and ... sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our **Physician Advisor ** , you will help our client facilities navigate the path… more
- The Cigna Group (St. Louis, MO)
- …operational data to identify trends, gaps, and opportunities for improvement in patient care delivery. + Translate complex data into clear, actionable insights ... **Job Summary** The Healthcare Strategy Advisor plays a key role in supporting the...key role in supporting the development and execution of clinical strategies that drive improved health outcomes, affordability, and… more
- US Tech Solutions (NJ)
- …eligibility for youth up to age 18. + Psychologist Advisor also assists with clinical reviews of complex cases, quality of care concerns, and offers ... that adheres to best practice standards. + The position will participate in clinical activities associated with children's system of care program initiatives. +… more
- CVS Health (Springfield, IL)
- …6. Stakeholder Collaboration: Collaborate closely with internal teams, including clinical and operational leadership, value-based care , quality management ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- The Cigna Group (Morristown, NJ)
- …WILLING TO COMMUTE LOCALLY TO THE OFFICE AND PROVIDERS** The **Provider Contracting Advisor ** serves as an integral member of the Provider Contracting Team and ... for a local given territory. **DUTIES AND RESPONSIBILITIES** + Manages complex contracting and negotiations for fee for service and value-based reimbursements… more