- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Physician Advisor position is responsible for teaching, consulting, and advising the case management department, clinical documentation ... is a key member and leader of the hospital's utilization review /management committee, which is charged with...of healthcare quality and acceptable levels of cost. The Physician Advisor position will conduct clinical reviews… more
- CommonSpirit Health (Houston, TX)
- …a remote position and you must be licensed in the state of Texas. As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews ... providing quality patient care, to assure effective and efficient utilization of health care services. The PA communicates remotely...+ Minimum of 1 year of experience as a Physician Advisor preferred. + Minimum of 5… more
- Houston Methodist (Houston, TX)
- …clinical protocols. + Escalates appropriate cases to the Physician Advisor (or services) for appropriate second level review , peer-peer discussions, ... At Houston Methodist, the Utilization Review Nurse (URN) position is...and payer denial- appeal needs. Consults with physician advisor as necessary to resolve progression-of-care… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry,...efficient use of resources and seeks assistance from the Physician Advisor when necessary. Informs management of… more
- CVS Health (Austin, TX)
- …Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. **Education** * Active and current ... program/operational efficiency involving clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including the… more
- Houston Methodist (The Woodlands, TX)
- …the external case manager to facilitate discharge planning, seeks assistance from the physician advisor , if needed, and informs management of the possible need ... improvements, patient satisfaction). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care team to… more
- Houston Methodist (Houston, TX)
- …the external case manager to facilitate discharge planning, seeks assistance from the physician advisor , if needed, and informs management of the possible need ... improvements, patient satisfaction. **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional healthcare team to… more
- CVS Health (Austin, TX)
- …working at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization a Plus **Preferred Qualifications:** ... -Health plan/payor Utilization Management / Review experience -Electronic medical systems/record experience -Managed Care experience -Medicaid experience… more
- HCA Healthcare (San Antonio, TX)
- …triage care etc. + Contracts impacted by the emergency department. + On call physician panel reviews and proper utilization . + Supply chain optimization and ... that impact ED throughput 4. Supply, medication, and resource utilization 5. Appropriate assignment of patients being admitted to...and analysis of variances. + Perform data mining and review of financial and clinical data to assess the… more
- Fresenius Medical Center (Round Rock, TX)
- …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