- Intermountain Health (Raleigh, NC)
- **Job Description:** Physician will provide Physician Advisor Utilization Reviewer and Central Appeals Work services. Physician shall engage, ... as an expert and local resource to hospital Case Management Department and Medical Staff on issues relating to... Utilization Review ("UR") Committee and provide Regional Physician Advisor Educators information to be shared… more
- UNC Health Care (Raleigh, NC)
- …stay, and discharge reviews in accordance with federal regulations & the Hospitals? Utilization Management Plan. In addition, the Utilization Manager is ... case management referrals. Initiates appropriate social work referrals. 3. Utilization Management Process - Performs utilization management… more
- Huntington National Bank (Charlotte, NC)
- Description Job Summary: As a Treasury Management Advisor III - Corporate Healthcare, you will play a pivotal role in driving the growth and success of our ... In this role, you will act as a trusted advisor to both clients and prospects, providing insightful guidance...Leadership: Oversee portfolio performance, ensuring revenue growth and high utilization of treasury solutions + Risk Management … more
- UNC Health Care (Kinston, NC)
- …and other payor regulations. 3. Reviews all denials and works collaboratively with the Physician Advisor and Case management Assistants. 4. Reviews and ... clinical documentation and formulates appropriate appeals. Coordinates with the Physician Advisor and Case management ...experience as a Registered Nurse required. + 2 years utilization review, care management , or compliance experience… more
- UNC Health Care (Hendersonville, NC)
- …management referrals. Initiates appropriate social work referrals. + Performs utilization management assessments and interventions, using collaboration with ... well-being of the unique communities we serve. Summary: The Utilization Manager (UM) assesses new admissions, continued stay and...correct computer system in a timely manner. Consults with Physician Advisor as necessary to resolve barriers… more
- UNC Health Care (Rocky Mount, NC)
- …barriers according to escalation process; if the barrier is clinical in nature, refer to Physician Advisor and escalate to the ED Case Manager for all other ... Frequent ED Utilization . Develop and maintain care plans for active management of patients who frequently seek ED care-Track high frequency users-Assess reasons… more
- Fresenius Medical Center (Fayetteville, NC)
- …departments and external customers; particularly in problem resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. + ... and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely… more
- UNC Health Care (Chapel Hill, NC)
- …of questionable clinical or administrative appropriateness per established guidelines to the Care Management Physician Advisor and/or Care Management ... through the integrating and functions of point of entry case management , utilization review, and effective patient flow activities. Responsibilities: 1. Capacity… more