- Nuvance Health (Danbury, CT)
- …Works to lead standardization of policy, procedure and approach to physician advisor roles in utilization management, , documentation and denials/downgrades. ... Manages processes, policies, workflows and overall management of the physician advisor role within the organization. *...Prevention and Denial Management teams with complex cases requiring Physician Advisor expertise to support both peer… more
- Nuvance Health (Danbury, CT)
- …prioritize improvement efforts, and negotiate with payers for fair reimbursement. * * Physician Advisor Collaboration:* Collaborate with the physician ... committee meetings. * *Utilization Review (UR):* * *Proactive UR:* Lead a team of UR nurses to conduct timely...* *Denials Management & Appeals:* * *Root Cause Analysis:* Lead a specialized team to thoroughly investigate claims denied… more