• Alameda Health System (San Leandro, CA)
    …necessarily performed by each individual in the classification. + Coordinates all utilization review functions, including response to payor requests for ... guidelines; refers questionable cases to the CM Manager or physician advisor for determination. + Takes appropriate...experience in Case Management in an acute setting or utilization review at a medical group or… more
    DirectEmployers Association (10/15/25)
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  • Fresenius Medical Care (Dallas, PA)
    …and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. Responsible ... staff in problem solving. PHYSICIANS: Facilitates the application process for physician privileges and compliance with FMS Medical Staff By-Laws. Responsible for… more
    Talent (10/25/25)
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  • Alameda Health System (San Leandro, CA)
    …action when cases do not meet criteria - coordinates denials with the attending physician , and the UR physician advisor . Prepares case reports; documents ... preferred. Minimum Experience: Two years related in acute care facility and/or utilization review training. Minimum Experience: Varied clinical experience or… more
    DirectEmployers Association (08/07/25)
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  • Physician Advisor

    Sutter Health (Sacramento, CA)
    …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the ... 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 (10/29/25)
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  • 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 (10/28/25)
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  • Inpatient Utilization Review

    Emory Healthcare/Emory University (Atlanta, GA)
    …judgement, and discussions with the attending physician and/or physician advisor . This individual will: + Perform utilization review by completing ... + And more **Description** We're seeking an **Inpatient Registry Utilization Review Nurse (PRN)** who is responsible...documentation of authorized, unauthorized or denied days to the Physician and the care team in order to reduce… more
    Emory Healthcare/Emory University (10/20/25)
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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 (09/06/25)
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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 | Case Management

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Physician Advisor position is responsible for teaching, consulting, and advising the case management department, clinical documentation ... is a key member and leader of the hospital's utilization review /management committee, which is charged with...of healthcare quality and acceptable levels of cost. The Physician Advisor position will conduct clinical reviews… more
    Houston Methodist (09/26/25)
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  • Director Physician Advisor

    Catholic Health Services (Melville, NY)
    …and presents to Physician Advisors during the monthly Physician Advisor meeting. + Attends hospital Utilization Management (UM) committees. + Supervises ... Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC...of CM processes and policies, as well as the Physician Advisor role, activities and expectations. +… more
    Catholic Health Services (09/26/25)
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