- Dignity Health (Carmichael, CA)
- **Responsibilities** ** Physician Advisor - Champion Quality Care at Dignity Health Mercy San Juan Medical Center** Are you a physician leader passionate ... Level 2 Trauma Center in Sacramento, CA, is seeking a dedicated and experienced Physician Advisor to join our team and play a pivotal role in shaping the future… more
- Sutter Health (Modesto, CA)
- …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the ... and the hospital to appropriately optimize the use of Sutter Health Internal Physician Advisor Services (IPAS). The physician Advisor will work closely… more
- Sutter Health (Modesto, CA)
- …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the ... and the hospital to appropriately optimize the use of Sutter Health Internal Physician Advisor Services (IPAS). The physician Advisor will work closely… more
- Dignity Health (Carmichael, CA)
- …hospital or office environment (Required). + 2+ years of work experience as a Physician Advisor (Preferred). + Membership in the American College of Physician ... Level 2 Trauma Center in Sacramento, CA, is seeking a dedicated and experienced Physician Advisor to join our team and play a pivotal role in shaping the future… 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 ... flow/throughput management, ancillary services utilization and clinical documentation improvement. The Physician Advisor reviews clinical cases to provide a … more
- Veterans Affairs, Veterans Health Administration (Loma Linda, CA)
- …is required; 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
- The County of Los Angeles (Los Angeles, CA)
- …pertaining to Medicare and Medi-Cal reimbursement. + Analyzes cases for referral to the physician advisor to ensure that the admission or continued stay is being ... appropriate screening criteria and standards; serves as the liaison with the physician advisor for the referral of unusual questionable cases, on referred cases… more
- The County of Los Angeles (Los Angeles, CA)
- …and analyzes reports prepared by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of physician advisor ... Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the Utilization Review Committee, the incumbent is responsible… more
- LA Care Health Plan (Los Angeles, CA)
- …and implement a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service and ... High risk/high cost cases and reports are maintained and referred to the Physician Advisor /UM Director. Document in platform/system of record. Utilize designated… more
- Alameda Health System (San Leandro, CA)
- …action when cases do not meet criteria - coordinates denials with the attending physician , and the UR physician advisor . Prepares case reports; documents ... disposition of Medi-Cal, self-pay, and out-of-plan patients, including working with physician to determine readiness for transfer, securing placement and completing… more
- Sedgwick (West Hills, CA)
- …and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability ... disability plan. + Reviews and analyzes complex medical information (ie attending physician statements, office notes, operative reports, etc.) to determine if the… more
- Alameda Health System (Oakland, CA)
- …(eg, inpatient, observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet ... correct patient class upon admission and providing education to enhance physician understanding of patient classification criteria. **DUTIES & ESSENTIAL JOB… more
- Sharp HealthCare (La Mesa, CA)
- …utilization management venues.Escalate and refers cases for consultation with Physician Advisor or Medical Director as appropriate.Oversee preparation, ... a comprehensive plan of care for each patient/family in collaboration with the physician , social worker and all members of the interdisciplinary team in the… more
- Sharp HealthCare (San Diego, CA)
- …utilization management venues.Escalate and refers cases for consultation with Physician Advisor or Medical Director as appropriate.Oversee preparation, ... a comprehensive plan of care for each patient/family in collaboration with the physician , social worker and all members of the interdisciplinary team in the… more
- Sedgwick (West Hills, CA)
- …and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability ... + Negotiates return to work with or without job accommodations via the claimant's physician and employer. + Refers cases as appropriate to team lead and clinical… more
- Travelers Insurance Company (Rancho Cordova, CA)
- …+ Engage specialty resources as needed to achieve optimal resolution (Dial-a-doc, physician advisor , peer reviews, MCU). + Partner with Claim Professional ... to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome. + Utilize internal Claim Platform Systems to manage all claim activities on a timely basis. + Utilize Preferred Provider Network per… more
- Alameda Health System (Oakland, CA)
- …(eg, inpatient, observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet ... medical necessity criteria. 4. Review admission orders and documentation to confirm alignment with regulatory requirements and payer guidelines. 5. Review planned admissions to ensure that services are medically necessary, appropriately authorized by the… more
- UCLA Health (Los Angeles, CA)
- Description The Physician Assistant Supervisor reports to the designated medical director for clinical practice and designated person for administrative issues. Key ... Unit Director of the Main Operating Room or designee, this candidate is an active physician assistant, working 65% of their time as a Robotic PA in the Operating… more
- UCLA Health (West Hills, CA)
- Description This candidate is an active physician assistant, working 80% of their time in their designated clinical specialty and 20% of their time in administrative ... the practice of advanced healthcare professionals (AHP), including nurse practitioners and physician assistants. Ensures quality of care and serves as a role model,… more
- Sharp HealthCare (San Diego, CA)
- …physicians (Medical Directors (both medical and behavioral health) and the Physician Reviewers) to coordinate the necessary co-management of our members related ... health and pharmacy needs. This position also provides the physician cohesive collaboration necessary for the continuum of care...membership. Serves as a lead medical manager and policy advisor to SHP clinical and its' Chief Medical Officer.… more