- Sutter Health (Sacramento, CA)
- …Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the hospital's ... care services. The PA will develop expertise on matters regarding physician practice patterns, over- and under-utilization of resources, medical necessity,… more
- CareOregon (Portland, OR)
- …non-dominant groups within Housecall Providers and our communities at large. The quadruple aim is real at Housecall Providers In home medical care for homebound ... on the satisfactory completion of a pre-employment background check, immunization review , and drug screen (including THC/Marijuana). CareOregon is a federal… more
- ChenMed (Warren, MI)
- …patient's primary care physician to meet urgent patient needed with the aim of preventing unnecessary hospital arrivals + Performs other duties as assigned and ... other members of the care team that provides hyperfocus case management and field nursing interventions to prevent unnecessary...episode of care management the register nurse (RN) will review patient chart for discharge and conduct final discharge… more
- CareOregon (Portland, OR)
- …non-dominant groups within Housecall Providers and our communities at large. The quadruple aim is real at Housecall Providers In home medical care for homebound ... on the satisfactory completion of a pre-employment background check, immunization review , and drug screen (including THC/Marijuana). CareOregon is a federal… more
- CareOregon (Portland, OR)
- …non-dominant groups within Housecall Providers and our communities at large. The quadruple aim is real at Housecall Providers In home medical care for homebound ... on the satisfactory completion of a pre-employment background check, immunization review , and drug screen (including THC/Marijuana). CareOregon is a federal… more
- CareOregon (Portland, OR)
- …non-dominant groups within Housecall Providers and our communities at large. The quadruple aim is real at Housecall Providers In home medical care for homebound ... on the satisfactory completion of a pre-employment background check, immunization review , and drug screen (including THC/Marijuana). CareOregon is a federal… more
- Elevance Health (Atlanta, GA)
- …state mandated policies, and CMS Coverage Determinations, as applicable. + Perform physician -level case review of utilization requests for procedures ... reviews for their board certified specialty. + Makes physician to physician calls to gather medical...necessity decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …case reviews and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides clinical expertise on ARD cases, ... and may require peer-to-peer discussions with providers regarding UM case review determinations. + Provides input into...of Medicine or Doctor of Osteopathic Medicine. + The Physician is not the subject of any pending professional… more
- ChenMed (Jacksonville, FL)
- …patient's primary care physician to meet urgent patient needed with the aim of preventing unnecessary hospital arrivals + Performs other duties as assigned and ... episode of care management the register nurse (RN) will review patient chart for discharge and conduct final discharge...may need and to oversee appropriate patient discharge from case management. + Performs clinical, fall prevention, and social… more
- Stanford Health Care (Palo Alto, CA)
- …revenue cycle certification- Health Care Quality (HACP, CPHQ, HCQM) certification- Case Management Certification (CCM) or clinical certification- Physician ... experience. + ICU/ED and Academic Medical Center experience preferred. + Case management, utilization review and/or direct provider interaction experience,… more
- Banner Health (Mesa, AZ)
- …24-hour Pediatric Intensivist coverage, and dedicated Respiratory Therapists, Nutritionists, Case Management, Social Services, PT/OT and Pharmacists. As a Registered ... that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of...50 busiest Emergency departments in the country. If you aim to deliver top-tier care to the most vulnerable… more
- Elevance Health (Costa Mesa, CA)
- …policies when making medical necessity decisions. + Brings to their supervisors attention, any case review decisions that require. + Medical Director review ... the Elevance Health family of companies, Carelon Medical Benefits Management, formerly AIM Specialty Health, is a benefit-management leader in Illinois. Our platform… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …reviews and peer-to-peer calls in timely manner and provides support for the Case Management (CM) and Registered Nurse (RN) reviewers and manages the denial process. ... rounds. + Provision of clinical oversight and leadership to Utilization Management/ Case Management (UM/CM) staff working with the children's population. + Develops,… more
- Tufts Medicine (Stoneham, MA)
- …and other disciplines to implement plan of care by participation in nursing, physician , and case management reporting rounds. 17. Delegates responsibilities to ... on providing professional and nonprofessional nursing care services in accordance with physician orders. In addition, this role focuses on performing the following… more
- CCSI INC (Johnson City, NY)
- …This includes communication with partnering agencies, coordination and facilitation of complex case review sessions and partnering with existing Department staff ... and assist with the facilitation of SPOA Committee meetings. + Document and track case statuses and progress while under the supervision of SPOA. + Develop and… more
- Banner Health (Mesa, AZ)
- …and advanced technology that includes the da Vinci Surgical System. Becker's Hospital Review named Banner Desert Medical Center as one of the top 50 busiest ... Emergency departments in the country. If you aim to deliver top-tier care to the most vulnerable...upon admission. Orders outside records from other facilities and Physician 's offices. 3. Maintains a complete patient record with… more
- Cleveland Clinic (Cleveland, OH)
- …experience is available at the _Cleveland Clinic Lerner College of Medicine of Case Western Reserve University_ . Board Certification via the American Board of ... Pediatric Institute. Cleveland Clinic Children's and the Center for Pediatric Behavioral Health aim to create an equitable and engaging work environment in which all… more
- Mount Sinai Health System (New York, NY)
- …MSAHC guaranteeing adherence to all aspects of clinical service delivery, reporting, incident review , and high-risk case management + Knowledge of and ability to ... of interest and send CV with Cover Letter to:** ** Physician Recruitment Department** **Mount Sinai Health System** **###@mountsinai.org** **Responsibilities**… more
- Premier Health (Middletown, OH)
- …and growth . Meet on a regular basis with clinical supervisor to review case workload. **Essential Duties & Functions** **Essential Duties & Functions:** ... The **_Social Worker_** will be an integral member of the AIM multidisciplinary team. Together with nurses and community health coaches, the… more
- CVS Health (Jefferson City, MO)
- …and underutilization of health care services in alignment with the Quintuple AIM . 3. Participates with plan leaders in identification and developing the appropriate ... competitive business advantage by supporting the plan goals. 2. Review , interpret and analyze data and trends at State...to identify and effectively manage emerging utilization trends, large case reviews, and out of state service requests. 5.… more