- CommonSpirit Health (Englewood, CO)
- **Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews referred by case ... patients and alternative levels of care. **The PA performs denials management and prevention in accordance with...required + **Minimum 3 years of experience as a Physician Advisor ** **managing denials required**… 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 ... difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth Israel… more
- Kaleida Health (Buffalo, NY)
- …as facilitating strong working relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments ... where diversity is valued and celebrated!_ **Position** Director Clinical and DRG Denials **Location** US:NY:Buffalo | Management | Full-Time **Req ID** null… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …patients, regulatory compliance, and utilization management (including LOS). 4. The Physician Advisor should discuss his/her role with the Hospital CMO, or ... **Responsibilities** 1. The Physician Advisor serves the Hospital through...Establish and champion successful relationships with Care Coordination (Utilization Management , Denials Management , and Progression/Transition… more
- HonorHealth (AZ)
- …across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The System Physician Advisor (PA) serves as a liaison between the hospital ... and state utilization and quality regulations. As a CDI physician advisor , the PA will act as... management of long LOS patients. Assists case management with development and communication of physician … more
- Catholic Health Services (Melville, NY)
- …presents to Physician Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. Supervises the ... with management in recruiting new Catholic Health Physician Advisor hires. Trains new Physician...admission criteria for all levels of care). Experience with denials management . Knowledge of clinical, quality, and… more
- AdventHealth (Orlando, FL)
- …questions from Utilization Management staff involved in authorizations, concurrent review, and denials as a back up to UM Physician Advisory as and when ... AND JOB RESPONSIBILITIES** **:** Provides clinical support/validation for Care Management , CDI and Quality teams. Provides education and serves...Regulations . Two years or greater experience as a Physician Advisor . Three years of leadership… more
- Trinity Health (Silver Spring, MD)
- **Employment Type:** Full time **Shift:** **Description:** **Position Title:** Physician Advisor **Type of Position:** Exempt **What We Offer:** Benefits, Free ... from Washington, DC, and Baltimore, MD. **Position Overview:** The Physician Advisor provides expertise related to appropriate...all levels of care) * Understanding of approaches to denials management * Knowledge of clinical, quality,… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on ... of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance… more
- CommonSpirit Health Mountain Region (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 ... partnership with the Medical Director CDI, Enterprise Director Case Management , UM Hub Director, and Care Coordination Leaders at...Committees or administrative roles, preferred. + Experience as a Physician Advisor in the acute care setting… more
- Ascension Health (Jacksonville, FL)
- **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Hybrid (frequently on site) + **Call ... **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
- Ascension Health (Hoffman Estates, IL)
- **Details** + **Specialty** : Physician Advisor + **Schedule:** Full Time | Onsite + **Practice Details:** Join experienced Case Management Team + **EMR** ... **Position Highlights** Ascension St. Alexius 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. This… 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...health plan, and clinical guidelines in the review of denials . Serve as a resource for physicians regarding… more
- AdventHealth (Maitland, FL)
- …than 32,000 inpatients and 125,000 outpatients each year **The role you'll contribute:** The Physician Advisor for CDI is a board-certified physician who ... of accurate, thorough documentation. Participate in mortality reviews, DRG downgrade denials management , and clinical validation processes. + Compliance and… more
- Hackensack Meridian Health (Manahawkin, 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 ... team, you will collaborate with the Chief Medical Officer and Care Management Department to ensure efficient and effective healthcare delivery. **Why Join Us?**… more
- Ascension Health (Jacksonville, FL)
- …time of the offer._ **Responsibilities** Ascension St. Vincent is looking for a Physician Advisor to join our Women's Health team. **Responsibilities:** + Review ... of stay determination. + Assist and manage the denial management process. + Review and offer suggestions related to...life care. + Develop strategy and processes to reduce denials and audits. + Assist with appeal. + Utilize… more
- Billings Clinic (Billings, MT)
- …and coding. Analyzes and reports coding distribution and trends in clinical denials to providers and management . Analyzes payer bulletins and regulations ... a difference here. About Us Billings Clinic is a community-owned, not-for-profit, Physician -led health system based in Billings with more than 4,700 employees,… more
- AdventHealth (Altamonte Springs, FL)
- …record; * Escalating otherwise unresolved status conflicts appropriately and timely to the physician advisor to avoid concurrent denials . + Collaborates with ... the UM nurse is responsible for escalation to the Physician Advisor or designated leader for additional...for observation and inpatient stay visits to avoid unnecessary denials . Working in collaboration with facility Care Management… more
- Nuvance Health (Danbury, CT)
- …and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social work, and non-clinical ... of care, prevent readmissions, and optimize patient outcomes. * * Denials Management & Appeals:* * *Root Cause...efforts, and negotiate with payers for fair reimbursement. * * Physician Advisor Collaboration:* Collaborate with the … more
- Omaha Children's Hospital (Omaha, NE)
- …management due to medical necessity and works collaboratively with patient accounts, the physician advisor , and NCM in various aspects of denial management ... veterans and people with disabilities. **A Brief Overview** Utilization Management (UM) is a specialty area of Nursing Case...meeting acute care guidelines. * Works directly with NCM physician advisor . * Guides admitting physician… more