• Utilization Review Specialist, DH

    Nuvance Health (Danbury, CT)
    …rotate one weekend per month Summary: The purpose of the Utilization Management Nurse is to support the physician , the interdisciplinary team, and ... of care and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level medical necessity reviews… more
    Nuvance Health (07/03/25)
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  • Physician - Physician Advisor

    Ascension Health (Jacksonville, FL)
    …5 years of recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. If you are ready ... **Details** + **Department:** Case Management + **Schedule:** Part-time | Hybrid (frequently on...**Position Highlights** Ascension St. Vincent is looking for a Physician Advisor to join our team. We are looking… more
    Ascension Health (08/02/25)
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  • Physician - Physician Advisor

    Ascension Health (Hoffman Estates, IL)
    …years of recent work experience in a hospital setting, preferably with some Physician Advisory/ Utilization Management work experience. This position reports ... Time | Onsite + **Practice Details:** Join experienced Case Management Team + **EMR** **System:** Cerner + **Facility** :...**Position Highlights** Ascension St. Alexius is looking for a Physician Advisor to join our team. We are looking… more
    Ascension Health (05/14/25)
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  • Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required. Communicates ... changes from the Managed Care Department and applies to UM and appeals management processes. Works collaboratively with physicians, physician office staff and… more
    Catholic Health Services (07/24/25)
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  • Licensed Practical Nurse Utilization

    Intermountain Health (Las Vegas, NV)
    Management , under the supervision of a registered nurse or licensed physician , participates in utilization management and authorization processes in ... under the guidance and direction of a registered nurse (RN). **Skills** + Utilization Management + Case Management + Medical Terminology + Communication +… more
    Intermountain Health (08/08/25)
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  • Director Physician Advisor

    Catholic Health Services (Melville, NY)
    … Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. Supervises the Facility Physician ... develops standard system-wide implementation plans and policies. Works with system Care Management (CM) leadership and Catholic Health Physician Advisors (as… more
    Catholic Health Services (06/27/25)
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  • Provider Services Rep

    Parkview Health (Fort Wayne, IN)
    …least two years of comprehensive experience in managed healthcare, provider relations, utilization management or physician office experience Other ... Summary Responsible for the maintenance and management of provider contracts for Health Plan Services (HPS). Investigates and resolves concerns from providers,… more
    Parkview Health (08/07/25)
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  • Physician Liaison

    Boulder Community Hospital (Boulder, CO)
    …BCH services as well as reporting utilization trends to management . *Travels to targeted physician offices/practices throughout primary and secondary ... independent. Working closely with the Chief Business Officer and other key management personnel, the Physician Liaison assists in establishing and communicating… more
    Boulder Community Hospital (07/02/25)
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  • Licensed Physician Reviewer - Ortho…

    ChenMed (Miami, FL)
    …people to join our team. The Physician Reviewer is the primary physician reviewer for Utilization Management /Clinical Appropriateness review cases in our ... Process and Quality improvement in our developing area of Delegated Utilization Management . **ESSENTIAL JOB DUTIES/RESPONSIBILITIES:** + Provides Delegated… more
    ChenMed (06/05/25)
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  • Utilization Review Physician

    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 ... Hackensack University Medical Center. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management , and… more
    Hackensack Meridian Health (07/01/25)
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