• Physician Advisor

    Catholic Health Initiatives (Chattanooga, TN)
    …of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty Certification by the American Board of ... Review Physicians, Inc. (ABQAURP) preferred. + Business Degree **Overview** The Physician Advisor is a key member of CHI Memorial's leadership team and… more
    Catholic Health Initiatives (04/11/25)
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  • Manager Physician Advisor

    HCA Healthcare (Nashville, TN)
    …Do you want to join an organization that invests in you as a Manager Physician Advisor Coordination? At Parallon, you come first. HCA Healthcare has committed up ... the opportunity to make a difference. We are looking for a dedicated Manager Physician Advisor Coordination like you to be a part of our team. **Job Summary and… more
    HCA Healthcare (05/16/25)
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  • Physician Advisor

    Community Health Systems (Franklin, TN)
    **Job Summary** The Physician Advisor provides clinical expertise and guidance to support case management, utilization review, and quality improvement ... ensure adherence to best practices, and support efficient resource utilization. The Physician Advisor also assists in compliance with regulatory standards and… more
    Community Health Systems (03/26/25)
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  • Coord Physician Adv Ops

    Covenant Health Inc. (Knoxville, TN)
    Overview Physician Advisor Operations Coordinator, Revenue Integrity and Utilization PRN/OCC, Variable Hours, Day Shift Covenant Health Overview: Covenant Health ... to be named a Forbes "Best Employer" seven times. Position Summary: The Physician Advisor Operations Coordinator will perform activities to help facilitate… more
    Covenant Health Inc. (05/02/25)
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  • Medical Director WFH

    HCA Healthcare (Nashville, TN)
    …of mortality, and DRG assignments on their individual patient records. REPORTS TO:VP Physician Advisor Peer to Peer Services POSITION QUALIFICATIONS: + Licensed ... Board Certification. + Preferred work experience with the payors or as a physician advisor . EDUCATION AND EXPERIENCE: + Minimum of 5 years of experience in… more
    HCA Healthcare (05/16/25)
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  • Specialist-Denial II RN

    Baptist Memorial (Memphis, TN)
    …healthcare insurance providers in response to post-claim denials received by BMHCC. Physician Advisor communication may be necessary to provide further clinical ... options outside the formal appeal process. + Works closely with physician advisor for assistance with medically complex case appeals, hearings, or level… more
    Baptist Memorial (04/12/25)
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  • Specialist-Denial II RN

    Baptist Memorial (Memphis, TN)
    …healthcare insurance providers in response to post-claim denials received by BMHCC. Physician Advisor communication may be necessary to provide further clinical ... options outside the formal appeal process. + Works closely with physician advisor for assistance with medically complex case appeals, hearings, or level… more
    Baptist Memorial (04/11/25)
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  • Disability Representative Sr

    Sedgwick (Memphis, TN)
    …and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability ... disability plan. + Reviews and analyzes complex medical information (ie attending physician statements, office notes, operative reports, etc.) to determine if the… more
    Sedgwick (03/04/25)
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  • Nurse Medical Case Manager - Workers Compensation

    Travelers Insurance Company (Franklin, TN)
    …+ Engage specialty resources as needed to achieve optimal resolution (Dial-a-doc, physician advisor , peer reviews, MCU). + Partner with Claim Professional ... to provide medical information and disability status necessary to create an overall strategy to achieve an optimal outcome. + Utilize internal Claim Platform Systems to manage all claim activities on a timely basis. + Utilize Preferred Provider Network per… more
    Travelers Insurance Company (05/06/25)
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  • Director of Care Management

    Community Health Systems (Powell, TN)
    …and discharge planning. + Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. ... + Identifies avoidable days and implements communication systems to address and resolve them effectively. + Coordinates discharge planning and social services functions to ensure compliance with federal and state laws and Joint Commission standards. + Acts as… more
    Community Health Systems (04/27/25)
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