• Physician - Physician Advisor

    Ascension Health (Hoffman Estates, IL)
    **Details** + **Specialty** : Physician Advisor + **Schedule:** Full Time | Onsite + **Practice Details:** Join experienced Case Management Team + **EMR** ... **Position Highlights** Ascension St. Alexius is looking for a Physician Advisor to join our team. We...work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. This… more
    Ascension Health (08/13/25)
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  • Physician Advisor - Des Moines…

    Trinity Health (Des Moines, IA)
    … with Inpatient experience for a newly opened but established role as a Physician Advisor . The ideal candidate will have served on Hospital committees or ... working knowledge of CMS and commercial insurance regulations. The Physician Advisor must possess a team-building mindset...health plan, and clinical guidelines in the review of denials . Serve as a resource for physicians regarding… more
    Trinity Health (08/26/25)
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  • CDI Physician Advisor

    AdventHealth (Maitland, FL)
    …than 32,000 inpatients and 125,000 outpatients each year **The role you'll contribute:** The Physician Advisor for CDI is a board-certified physician who ... of accurate, thorough documentation. Participate in mortality reviews, DRG downgrade denials management , and clinical validation processes. + Compliance and… more
    AdventHealth (10/10/25)
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  • Physician Advisor

    Hackensack Meridian Health (Neptune City, NJ)
    …a highly motivated and experienced physician to join our team as a ** Physician Advisor ** . This vital role offers a unique opportunity to combine your ... team, you will collaborate with the Chief Medical Officer and Care Management Department to ensure efficient and effective healthcare delivery. **Why Join Us?**… more
    Hackensack Meridian Health (10/29/25)
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  • AVP Care Coordination

    Nuvance Health (Danbury, CT)
    …and strategy for system-wide care coordination, encompassing utilization review (UR), denials management , discharge planning, social work, and non-clinical ... of care, prevent readmissions, and optimize patient outcomes. * * Denials Management & Appeals:* * *Root Cause...efforts, and negotiate with payers for fair reimbursement. * * Physician Advisor Collaboration:* Collaborate with the … more
    Nuvance Health (09/10/25)
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  • Director Case Management

    Brockton Hospital (Brockton, MA)
    …review, denials , appeals and reconsideration hearings. Works closely with the physician advisor to proactively intervene in cases where utilization of ... PURPOSE OF POSITION: The Director of Case Management is responsible for planning, directing, and managing of the activities of the Case Management Program for… more
    Brockton Hospital (09/12/25)
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  • Case Manager - Case Management

    Arnot Health (Elmira, NY)
    …Maintains a working relationship with Physician Advisor regarding physician issues related to auths/ denials . 9. Provide insurance companies with ... $10,000 Sign on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and… more
    Arnot Health (08/08/25)
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  • System VP Utilization Management

    CommonSpirit Health (Phoenix, AZ)
    …of federal, state and payer regulatory and contract requirements. + Previous Physician Advisor /Care Management or equivalent experience. Excellent ... an integrated system-wide utilization management program which includes comprehensive denials management . This role is critical to maintaining the… more
    CommonSpirit Health (09/05/25)
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  • Per Diem RN - Case Management - Sharp…

    Sharp HealthCare (La Mesa, CA)
    management venues.Escalate and refers cases for consultation with Physician Advisor or Medical Director as appropriate.Oversee preparation, delivery ... of care for each patient/family in collaboration with the physician , social worker and all members of the interdisciplinary...3 Years Recent acute care nursing experience or case management experience. + California Registered Nurse (RN) - CA… more
    Sharp HealthCare (09/06/25)
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  • Nurse, Care Management

    Alameda Health System (Oakland, CA)
    …criteria. Escalates to the attending physician , and the Care Management physician advisor of any concurrent denials . + Prepares case reports; ... Nurse, Care Management + Oakland, CA + Highland General Hospital...guidelines; refers questionable cases to the CM Manager or physician advisor for determination. + Takes appropriate… more
    Alameda Health System (10/18/25)
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