- Evolent (Springfield, IL)
- …where required, refers all cases that an approval cannot be rendered to the Physician Clinical Reviewer . In States where allowed, will make denial determinations ... the culture. **What You'll Be Doing:** As a Clinical Reviewer , Speech Therapy you will be a key member...to make a difference in patients' lives, in a non -clinical environment. You can enjoy better work- life balance… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr CMC- Clear Lake Center **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2505026 The ... in research activities/projects + Provides assistance regarding clinical issues to non -nursing utilization review staff + Demonstrates support of the… more
- Veterans Affairs, Veterans Health Administration (Jackson, MS)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... additional vacancies. VA offers a comprehensive total rewards package. VHA Physician Total Rewards. Education Debt Reduction Program (Student Loan Repayment): Learn… more
- Hackensack Meridian Health (Hackensack, NJ)
- The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical ... Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management,...posted rate of pay based on a number of non -discriminatory factors, including but not limited to: + Labor… more
- HonorHealth (AZ)
- …a hospital notice of non -coverage/Important Message from Medicare. Discusses the case with the attending physician and if additional clinical information is ... attending or consulting physicians as requested. If indicated, advises case management to render letter of non -coverage...reviewing a particular patient record. Assists with identifying a physician to review such record. Acts as… more
- Beth Israel Lahey Health (Cambridge, MA)
- …not meeting acute hospital level of care criteria and reports them to the physician reviewer . 7. Works with patients and families to facilitate post hospital ... care teaching hospital affiliated with Harvard Medical School. The Inpatient Case Manager (CM) performs utilization reviews and coordinates discharge planning for… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …/ Commercial Payors, as needed * Reviews medical records of patients identified by case managers/utilization review nurses, or as requested by other members of ... regarding federal and state utilization and quality regulations * Act as physician liaison between case management/utilization management and providers to… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the ... billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of...of admission and continued stay, severity, and morbidity/mortality. + Review patient status when admission criteria is non… more
- Ellis Medicine (Schenectady, NY)
- …by the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration with physicians and social workers ... years of inpatient experience in a hospital environment preferred. + Previous case management, utilization review , and discharge planning experience highly… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …physician will abide by all VA facility By Laws regarding the supervision of physician assistants and review of medical charting. v. The provider will perform ... organizations. Verification of accreditation may be made obtained from Accreditation Review Commission on Education of Physician Assistant. Note: Only… more