• CDI Physician Advisor

    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
    Penn Medicine (10/17/25)
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  • Case Management Manager - UPMC

    UPMC (Washington, PA)
    …with management of departmental budget. + Collaborates with Director, Medical Director/ Physician Advisor and staff to ensure effective processes and systems ... Case Management functions: training, auditing, systems support: Case Management Technology, InterQual, Concurrent Denials and reporting. Leads efforts… more
    UPMC (10/10/25)
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  • RN Case Manager (Part Time) - West Penn Hospital

    Highmark Health (Pittsburgh, PA)
    …for denial trends with the care coordination teams, performance improvement teams, physicians/ physician advisor and third party payers. + Maintains a working ... coordination of care in accordance with recognized standards of practice for Care Management . Professional role model utilizing expertise in care management to… more
    Highmark Health (09/13/25)
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  • RN Clinical Review Appeals Specialist

    St. Luke's University Health Network (Allentown, PA)
    …assignment of documented medical care for appropriate reimbursement. + Work with the physician advisor in review of patient medical records identified by ... of diagnosis and procedure code assignment and MS-DRG/APR-DRG accuracy based on denials or audit findings from government and commercial payers. Meet or exceed… more
    St. Luke's University Health Network (10/28/25)
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