- CommonSpirit Health (Englewood, CO)
- **Responsibilities** **Thi** **s is a remote position** The Utilization Management Physician Advisor II (PA) conducts clinical case reviews referred by case ... 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
- 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
- Dayton Children's Hospital (Dayton, OH)
- …to the Manager of Utilization Management and in partnership with the Physician Advisor provider team, Revenue Cycle leadership, Integrated Care Management ... Management ; supports the development and implementation of a comprehensive denials management program. This role functions as a hospital liaison with external… more
- Kaleida Health (Buffalo, NY)
- …as facilitating strong working relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments ... where diversity is valued and celebrated!_ **Position** Director Clinical and DRG Denials **Location** US:NY:Buffalo | Management | Full-Time **Req ID** null… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …patients, regulatory compliance, and utilization management (including LOS). 4. The Physician Advisor should discuss his/her role with the Hospital CMO, or ... **Responsibilities** 1. The Physician Advisor serves the Hospital through...Establish and champion successful relationships with Care Coordination (Utilization Management , Denials Management , and Progression/Transition… more
- AdventHealth (Altamonte Springs, FL)
- …Altamonte Springs, FL **The role you will contribute:** The Physician Advisor provides primary support for Utilization Management (UM) and secondary support ... documentation, patient safety, and quality outcomes. Through primary support of Utilization Management , the Physician Advisor is responsible for providing… more
- Northwell Health (Melville, NY)
- …defends level of care and medical necessity for assigned case. Collaborates with physician advisor , payor representative and site case managers to facilitate ... Review standard and regulations. Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts clinical reviews… more
- Trinity Health (Silver Spring, MD)
- …procedure and approach to physician advisor roles in utilization management , length of stay, denials /downgrades. Serves as physician expert and ... throughout 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
- Catholic Health Services (Melville, NY)
- …presents to Physician Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. Supervises the ... with management in recruiting new Catholic Health Physician Advisor hires. Trains new Physician...admission criteria for all levels of care). Experience with denials management . Knowledge of clinical, quality, and… more
- AdventHealth (Orlando, FL)
- …questions from Utilization Management staff involved in authorizations, concurrent review, and denials as a back up to UM Physician Advisory as and when ... AND JOB RESPONSIBILITIES** **:** Provides clinical support/validation for Care Management , CDI and Quality teams. Provides education and serves...Regulations . Two years or greater experience as a Physician Advisor . Three years of leadership… more
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