- 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
- UNC Health Care (Kinston, NC)
- …payor regulations. 3. Reviews all denials and works collaboratively with the Physician Advisor and Case management Assistants. 4. Reviews and documents ... gathers required clinical documentation and formulates appropriate appeals. Coordinates with the Physician Advisor and Case management Assistants in order… 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
- Virginia Mason Franciscan Health (Burien, WA)
- …patients, regulatory compliance, and utilization management (including LOS). 4. The Physician Advisor should discuss his/her role with the Hospital CMO, or ... We are seeking a physician with leadership experience interested in our new Physician Advisor position. This position will work with our St. Anne Hospital in… more
- Northwell Health (Melville, NY)
- …level of care and medical necessity for assigned case. + Collaborates with physician advisor , payor representative and site case managers to facilitate ... coding issues and knowledge gaps. Job Responsibility + Serves as liaison between the patient and facility/ physician and the third party payer. + Prepares and defends… more
- Carle Health (Champaign, IL)
- … and clinical denials management . + The Behavioral Health Physician Advisor is also expected to onboard the new providers regarding utilization ... with our Utilization Management RN team, Clinical Denials Management team and the Physician Advisor Team which is comprised of five other physicians.… 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
- 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
- Penn Medicine (Philadelphia, PA)
- …Monument Road, Bala Cynwyd, PA Hours: M-F, 8hr days, hybrid Summary: + The CDI Physician Advisor is a key member of the healthcare organization's leadership team ... (approximately 80%) with a clinical component (approximately 20%).The CDI Physician Advisor will act as a resource...staff, and all areas of clinical documentation improvement, CEQI, denials management , coding, utilization management … more
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