- CommonSpirit Health (Englewood, CO)
- **Job Summary and Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews ... 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
- Nuvance Health (Danbury, CT)
- …support inpatient level of care. If the case still does not meet, send to the Physician Advisor (PA) for a second level review. * Forward cases that require ... secondary physician review to appropriate resource (eg, Physician Advisor ). * Resolve any discrepancy at...appeals and communicating on a daily/regular basis with the Denials Management team. * Assists with informing… 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 ... We are seeking a physician with leadership experience interested in our new Physician Advisor position. 1. The Physician Advisor serves the… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Physician Advisor position is responsible for teaching, consulting, and advising the case management department, clinical ... of healthcare quality and acceptable levels of cost. The Physician Advisor position will conduct clinical reviews...team, in order to assist with the identification and management of denials . Make suggestions related to… 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
- Nuvance Health (Danbury, CT)
- …procedure and approach to physician advisor roles in utilization management , , documentation and denials /downgrades. * Serves as physician expert ... the organization. * Manages processes, policies, workflows and overall management of the physician advisor ...all levels of care) * Understanding of approaches to denials management * Familiarity with clinical documentation… more
- Penn Medicine (Philadelphia, PA)
- …Monument Road, Bala Cynwyd, PA Hours: M-F, 8hr days, hybrid Summary: + The CDI Physician Advisor is a key member of the healthcare organization's leadership team ... (approximately 80%) with a clinical component (approximately 20%).The CDI Physician Advisor will act as a resource...staff, and all areas of clinical documentation improvement, CEQI, denials management , coding, utilization management … more
- AdventHealth (Orlando, FL)
- …inpatients and 125,000 outpatients each year **The role you'll contribute:** As the physician advisor (PA), this role educates, informs, and advises members of ... our contracted managed care payers. The PA role is responsible for providing physician review of utilization, claims management , and quality assurance related to… 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 (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 (Austin, TX)
- **Details** + **Specialty** : Case Management + **Subspecialty:** Physician Advisor + **Schedule** : Full Time | Remote (with some on-site prescense ... Highlights** Ascension in Austin, TX is looking for a Physician Advisor to join our team. We...setting (Adult Medicine Hospitialist experience preferred), preferably with some Physician Advisory/ Utilization Management work experience. If… 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
- 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 (Orlando, 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 (Neptune City, 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
- Beth Israel Lahey Health (Beverly, MA)
- …attends denials meetings. The denials specialist coordinates with the Physician Advisor retroactive and concurrent denials . This position reports ... identifying the issues and providing a proactive appropriate to pre-certification denials management . Serves as a liaison and mentor to the multidisciplinary… 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
- Guthrie (Sayre, PA)
- …tools and peer-reviewed journals. + Provides clinical denial management assistance to Physician Advisor and denials team. + Ensure compliance with all ... external requests for information, data, and /or education specific to clinical denials management . + Collaborates with revenue cycle team (business, billing,… more