- LifePoint Health (Rutherfordton, NC)
- …and concurrent medical record review .2. Documents utilization review in accordance with departmental guidelines.3. Facilitates physician documentation of ... outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources,...follows established reporting procedures.12. Refers cases and issues to Physician Advisor in compliance with Department procedures… more
- UPMC (Media, PA)
- …+ Develops and maintains effective relationships with providers. + Serves as physician advisor for UPMC Passavant McCandless and UPMC Passavant Cranberry ... members. This includes significant responsibility for quality management and utilization management and for assuring the adequacy of the...would join a highly educated and motivated team of physician advisors at CCBHO who advocate well for the… more
- Mount Sinai Health System (New York, NY)
- …**Experience Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. ... a Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...rate. h. Appropriately identifies and refers cases to the physician advisor to support timely progression of… more
- Tenet Healthcare (Detroit, MI)
- …include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review , b) care coordination, c) transition ... patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patients resources and...on Medical Necessity process and submits case for Secondary Physician review per Tenet policy. Ensures timely… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... medical record and provides information to the department head as indicated. + Utilization review and utilization managementThe RN CM I will:Conduct… more
- Mount Sinai Health System (New York, NY)
- …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...rate. 8. Appropriately identifies and refers cases to the physician advisor to support timely progression of… more
- LifePoint Health (Hickory, NC)
- …admission and concurrent medical record reviews. * Documents utilization review per departmental guidelines. * Facilitates physician documentation to reflect ... outcome of care management as prescribed in the initial Utilization Review Plan with regard to resources,...populations and follows reporting procedures. * Refers cases to Physician Advisor or secondary reviewer and follows… more
- University of Michigan (Ann Arbor, MI)
- …position is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a balance ... software, such as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management** + Conduct clinical … more
- Ascension Health (Jacksonville, FL)
- …areas of responsibility, to include but not limited to; + Quality and Safety + Utilization Review + Peer Review and Credentialing + Growth and Strategic ... adherence and completion of medical staff decisions regarding peer review and physician behavioral issues. + Leads...principles for physician activities. + Serves as physician advisor to assist with level of… more
- Community Health Systems (Bentonville, AR)
- …and utilization of hospital services, escalating cases as needed to the Physician Advisor or Utilization Management (UM) committee. + Identifies ... collaborative care planning. + Ensures accurate and timely documentation of utilization review , discharge planning activities, and patient interactions in… more