- R1 RCM (Detroit, MI)
- …of documentation inconsistencies and DRG variances + Educates the CDI team and Physician Advisor on coding changes, DRGs, Official coding guidelines and ... coding liaison team also works with site customers including CDI, Quality/Risk, Case Management, Patient Advocate's, Physician Advisors, Clinical Departments and… more
- Alameda Health System (Oakland, CA)
- …(eg, inpatient, observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may not meet ... Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time -...three (3) years of experience in Utilization Management or Case Management AND proficiency in applying InterQual Criteria (95%… more
- CommonSpirit Health (Rancho Cordova, CA)
- …partnership with leadership across multiple levels (system, region, market, and hospital ) and disciplines including CNOs, CFOs, CMOs, CNOs, and departments such ... as Revenue Cycle, Payer Strategy, Community Health, Physician Enterprise Continuing Care, Quality, Performance Improvement, Ethics, and Legal. Serves as a proactive … more
- AdventHealth (Tampa, FL)
- …of contact for all identified stakeholders [i.e. Utilization Management staff, Physician Advisor (s), payors, leadership] Qualifications **The expertise and ... Tampa AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital located in the uptown district of Tampa, Florida, specializes in… more
- New York State Civil Service (Orangeburg, NY)
- …on evenings, weekends, and during off hours.4. Serve as health advisor to multi-disciplinary team; provide consultation/peer review to other physicians/clinicians; ... supervise nurse practitioners and/or physician assistants; actively participates in activities intended to improve...is general medical experience in a private, clinical, or hospital medical practice which includes diagnosing and treating illness… more
- UNC Health Care (Hendersonville, NC)
- …data into the correct computer system in a timely manner. Consults with Physician Advisor as necessary to resolve barriers through appropriate administrative and ... change review as trigger by patient admission to the hospital to ensure appropriateness of the setting and timely...Bachelor's of Science in Nursing (BSN) + Certification in Case Management **Job Details** Legal Employer: Pardee - HCHC… more
- CVS Health (Phoenix, AZ)
- …experience with a Health Plan / Payor. Previous UM experience as a Physician Advisor in a Health / Hospital system. **Education** Medical Doctor or Doctor of ... Director will provide clinical, coding, and reimbursement expertise as well as directing case management when necessary. This is a remote based (work from home)… more
- Beth Israel Lahey Health (Plymouth, MA)
- …and identifies trends/root causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee as appropriate. + ... Denials management manager - Full Time** **Who We Are:** At **Beth Israel Deaconess Hospital -Plymouth** , our patients always come first. We are proud to be a… more