- Penn Medicine (Philadelphia, PA)
- …with meeting the organization's goals and objectives for assuring the effective and efficient utilization of health care services. The Physician Advisor is a ... and utilization review departments and the hospital leadership. The Physician Advisor shall possess and/or develop expertise on matters regarding physician… more
- Highmark Health (Harrisburg, PA)
- …Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician... utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and… more
- Penn Medicine (Lancaster, PA)
- …Lancaster General Health is looking for an experienced RN to join our Utilization Management Specialist team! In this critical role, you'll advocate for patients by ... thrive under pressure, we'd love to hear from you!_ **Summary** : The Utilization Management Specialist - Admissions is responsible for evaluating medical records to… more
- Highmark Health (Harrisburg, PA)
- …coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by ... the physician against medical policy criteria. The incumbent then uses...prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to… more
- Penn Medicine (Philadelphia, PA)
- …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 and is ... primarily administrative (approximately 80%) with a clinical component (approximately 20%).The CDI Physician Advisor will act as a resource and liaison between our… more
- YesCare Corp (Philadelphia, PA)
- …justifications for non-formulary medication requests when necessary. + **Resource Utilization :** Resolve patient care issues using in-house resources before ... staff as requested. + Participate in quality care reviews and sponsor physician assistants or nurse practitioners as needed. + **Schedule Management:** Notify the… more
- Trinity Health (Woodlyn, PA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Primary Care Physician ** Shift: Monday - Friday 8 am to 5:00 pm Status: Full time Location: ... Purpose:** Under the supervision of the medical director, the Primary Care physician (PCP) provides primary medical care to PACE Organization (PO) participants,… more
- UPMC (Pittsburgh, PA)
- …time, every time? UPMC Community Medicine, Inc. is seeking a Primary Care Physician trained in Internal Medicine or Family Medicine to join Bedford Internal Medicine ... incentives, including a quality-based Value Incentive Plan, and an APP Utilization Plan. - Benefit highlights: Medical/dental/vision that starts on day one,… more
- Trinity Health (Woodlyn, PA)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** ** PHYSICIAN ** **Location:** Kinder Park **Status** **:** Full time **Incentives** **:** 1st Day ... Purpose: Under the supervision of the medical director, the Primary Care physician (PCP) provides primary medical care to PACE Organization (PO) participants,… more
- R1 RCM (Jenkintown, PA)
- …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Physician Advisor** , you will help our client facilities navigate the ... remote position. **Here's what you will experience working as a Physician Advisor:** + Addresses the following issues: authorization requested, documentation support… more