- Highmark Health (Pittsburgh, PA)
- …Case Managers, UM nurses, and the hospital leadership team. The Physician Advisor is an integral part of the Utilization Management Committee and ... medical necessity and appropriateness of: admission to the hospital, utilization of observation status and services for those patients,...the bi-weekly Throughput Meeting. + The Physician Advisor needs to be able to review … more
- UPMC (Media, PA)
- …+ Develops and maintains effective relationships with providers. + Serves as physician advisor for UPMC Passavant McCandless and UPMC Passavant Cranberry ... members. This includes significant responsibility for quality management and utilization management and for assuring the adequacy of the...would join a highly educated and motivated team of physician advisors at CCBHO who advocate well for the… more
- Penn Medicine (Philadelphia, PA)
- …conducts utilization management activities, communication with insurers, team, and physician advisor . Discharge planning activities such as : home care, ... appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor , with timely coordination of home care, DME,… more
- Penn Medicine (Philadelphia, PA)
- …appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor , with timely coordination of home care, DME, ... use of internal resources, communication with interdisciplinary care team and Physician Advisor Discharge planning activities: timely coordination of home… more
- Highmark Health (Monroeville, PA)
- …for denial trends with the care coordination teams, performance improvement teams, physicians/ physician advisor and third party payers. + Maintains a working ... knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.… more
- Penn Medicine (Philadelphia, PA)
- …must be a seasoned med/surg nurse with a minimum of 5 years' experience in Utilization review and 3 years of experience in the Transfer Center.** Summary: + ... appropriate use of internal resources, communication with interdisciplinary care team and Physician Advisor , with timely coordination of home care, DME,… more
- UPMC (Pittsburgh, PA)
- …requirements and that chart documentation supports LOC determination. + Works with Physician Advisor and Attending Physicians to obtain necessary documentation ... leadership role in concurrent denial process. Works with Care Management Director, Physician Advisor , Attending Physicians and clinical team to obtain necessary… more
- Fresenius Medical Center (Philadelphia, PA)
- …departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. + ... staff in problem solving. **PHYSICIANS:** + Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. + Responsible… more