• Manager - Utilization Review

    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 ... you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We Are:** At… more
    Beth Israel Lahey Health (12/14/25)
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  • Medical Director (Hybrid)

    CareFirst (Baltimore, MD)
    …+ Experience in utilization management or served as physician advisor for utilization review in healthcare entities. Previous experience working ... **Resp & Qualifications** **PURPOSE:** The Medical Director oversees all activities of utilization review , care management and quality to determine the medical… more
    CareFirst (11/20/25)
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  • Physician Advisor

    Virginia Mason Franciscan Health (Tacoma, WA)
    …and identification of trends in the over and under- utilization of resources. 2. The Physician Advisor should be a key member of the medical staff and take on ... the role as leader of the Hospital's utilization review /management committee, which is charged with...and utilization management (including LOS). 4. The Physician Advisor should discuss his/her role with… more
    Virginia Mason Franciscan Health (01/03/26)
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  • Behavioral Health Physician Advisor

    Carle Health (Champaign, IL)
    Overview Carle Health is seeking a ** Physician Advisor ** to help oversee the efficiency of care for our Behavioral Health team over the West, Central, and East ... (.5 FTE and 100% Virtual) + The Behavioral Health Physician Advisor is responsible for conducting clinical...responsible for conducting clinical case reviews referred by the Utilization Management Team, the Case Management Team, the Clinical… more
    Carle Health (12/20/25)
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  • Penn Medicine Physician Advisor

    Penn Medicine (Philadelphia, PA)
    …for assuring the effective and efficient utilization of health care services. The Physician Advisor is a physician serving the hospital through teaching, ... and advising the care management and utilization review departments and the hospital leadership. The Physician... review departments and the hospital leadership. The Physician Advisor shall possess and/or develop expertise… more
    Penn Medicine (12/06/25)
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  • Physician Advisor Lead

    Nuvance Health (Danbury, CT)
    …the organization. * Works to lead standardization of policy, procedure and approach to physician advisor roles in utilization management, , documentation and ... of hospitalization, LOC status, LOS management, continued stay decisions, clinical review of patients, utilization review activities, resource… more
    Nuvance Health (10/12/25)
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  • Physician Advisor

    Catholic Health Initiatives (Lexington, KY)
    … including the designated Quality Review Organization and external Medical Directors. The Physician Advisor in addition to assisting in the review of ... **Job Summary and Responsibilities** As a Physician Advisor , you will promote evidence-based...sessions. + Participates in the Case Management Process including Utilization Review and Proactive Discharge Planning. Articulates… more
    Catholic Health Initiatives (12/25/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …level of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure ... hospitals objectives, and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides the… more
    Mohawk Valley Health System (01/06/26)
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  • Care Progression Physician Advisor

    Sutter Health (Oakland, CA)
    …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Bay **Position Overview:** The Physician Advisor (PA) is a key member of the hospital's ... to appropriately optimize the use of Sutter Health Internal Physician Advisor Services (IPAS). The physician...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
    Sutter Health (12/17/25)
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  • Physician Advisor , Overlook Medical…

    Atlantic Health System (Summit, NJ)
    …from ABQAURP (The American Board of Quality Assurance and Utilization Review Physicians), AAPL (American Association for Physician Leadership's Physician ... in Management course), or CPUR (Certification Program in Utilization Review ), Institute for Healthcare Improvement courses, or physician advisor training… more
    Atlantic Health System (11/17/25)
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