• Clinical Denials Prevention & Appeals…

    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
    Nuvance Health (09/26/25)
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  • Physician Advisor Lead

    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
    Nuvance Health (10/12/25)
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  • AVP Care Coordination

    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
    Nuvance Health (09/10/25)
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  • Care Manager

    Eastern Connecticut Health Network (Manchester, CT)
    …and takes appropriate action when variances are identified. + Works with the Physician Advisor to ensure appropriateness of care, cost-effectiveness and best ... at the other hospital as needed. Reports to the Manager of Care Management . EDUCATION/CERTIFICATION + Graduate of an accredited school of Nursing + Baccalaureate… more
    Eastern Connecticut Health Network (10/11/25)
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