- Alameda Health System (San Leandro, CA)
- …Escalates to the attending physician , and the Care Management physician advisor of any concurrent denials .Prepares case reports;documents treatment ... Nurse, Care Management + San Leandro, CA + San Leandro...guidelines; refers questionable cases to the CM Manager or physician advisor for determination. + Takes appropriate… more
- Alameda Health System (San Leandro, CA)
- …when cases do not meet criteria - coordinates denials with the attending physician , and the UR physician advisor . Prepares case reports; documents ... Social Services + Part Time - Day + Care Management + $58.74 - $97.91 per hour + Req...of Medi-Cal, self-pay, and out-of-plan patients, including working with physician to determine readiness for transfer, securing placement and… more
- CommonSpirit Health (Englewood, CO)
- **Job Summary and Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews ... patients and alternative levels of care. **The PA performs denials management and prevention in accordance with...required + **Minimum 3 years of experience as a Physician Advisor ** **managing denials required**… more
- Beth Israel Lahey Health (Plymouth, MA)
- …trends/root causes of denials for discussion with the internal team, physician advisor and the Utilization Review Committee as appropriate. + Participate ... difference in people's lives.** Full Time **Job Description:** **Utilization Review & Denials management manager - Full Time** **Who We Are:** At **Beth Israel… more
- Nuvance Health (Danbury, CT)
- …support inpatient level of care. If the case still does not meet, send to the Physician Advisor (PA) for a second level review. * Forward cases that require ... secondary physician review to appropriate resource (eg, Physician Advisor ). * Resolve any discrepancy at...appeals and communicating on a daily/regular basis with the Denials Management team. * Assists with informing… more
- Kaleida Health (Buffalo, NY)
- …as facilitating strong working relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments ... where diversity is valued and celebrated!_ **Position** Director Clinical and DRG Denials **Location** US:NY:Buffalo | Management | Full-Time **Req ID** null… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …patients, regulatory compliance, and utilization management (including LOS). 4. The Physician Advisor should discuss his/her role with the Hospital CMO, or ... **Job Summary and Responsibilities** 1. The Physician Advisor serves the Hospital through...Establish and champion successful relationships with Care Coordination (Utilization Management , Denials Management , and Progression/Transition… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Physician Advisor position is responsible for teaching, consulting, and advising the case management department, clinical ... of healthcare quality and acceptable levels of cost. The Physician Advisor position will conduct clinical reviews...team, in order to assist with the identification and management of denials . Make suggestions related to… more
- HonorHealth (AZ)
- …across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The System Physician Advisor (PA) serves as a liaison between the hospital ... and state utilization and quality regulations. As a CDI physician advisor , the PA will act as... management of long LOS patients. Assists case management with development and communication of physician … more
- Nuvance Health (Danbury, CT)
- …procedure and approach to physician advisor roles in utilization management , , documentation and denials /downgrades. * Serves as physician expert ... the organization. * Manages processes, policies, workflows and overall management of the physician advisor ...all levels of care) * Understanding of approaches to denials management * Familiarity with clinical documentation… more
