to serve as its Clinical Physician Advisor. General Requirements: M-F, 8am-5pm Potential for remote work. Must reside... in AL, FL, GA, KY, NC, SC, TN, VA, or WV. Ensure appropriate denials management and utilization of health system resources...
Provider Outreach Engagement Advisor US-OR-PORTLAND Job ID: 25-41908 Type: Regular Full-Time System Office 1919... and Legacy Health Partners (LHP) provider members by establishing and maintaining a strong relationship with the physician...
but saving them. Together. The UM Medical Director/ Physician Advisor (UM MD/PA) reports to the Senior VP of Clinical... Operations with accountably to Chief Financial Officer and Chief Medical Officer. The UM Medical Director/Physician Advisor works...
. At least, two (2) years’ experience as a physician advisor or in a similar utilization management leadership role preferred... and operational leader for the physician advisor team, guiding the strategic execution of utilization review, medical necessity...
is looking for a dedicated physician advisor to join the Utilization Review Advisor team. This role will be full-time on-site position. The... Utilization Review Physician Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists...
Other Information: Prior experience in Utilization Management with hospital system or health system preferredAdditional Education Info... for utilization are compliant, accurate and consistent. Responsibilities: Makes decisions on referred individual patient cases...
in Utilization Management with 3-5 years' experience in Utilization Management Leadership Required *3-5 years' experience in acute... utilization management. Leads initiatives to support department strategy, i.e., length of stay, observation conversion, timely...
for assisting the Utilization Review RN, Physician Advisor, Revenue Integrity Team and HIM records release to obtain/validate..., providing prompt feedback to both the Utilization Review Coordinators and the Physician Advisor if an authorization...
Description Summary: The Utilization Management Nurse II is responsible for determining the clinical... approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the...
as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team... for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay...
as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team... for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay...
Imagine360 is seeking a Utilization Management, RN to join the team! The RN Utilization Management Nurse is responsible... Physician Advisor or peer reviewer per policy and procedures. Assess and review current treatment history to identify...
Weekly Hours: 40 Department: Utilization Management Overview of Position: Acts as part of a multidisciplinary team..., and assesses quality, identifying and reporting potential risk management issues. Utilization Management analyzes and trends...
as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team... for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay...
as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team... for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay...
” encounters with providers and appropriate others to facilitate and coordinate the Utilization Management process(es) activities.... Accessing and applying Medical Guidelines for decision-making before Medical Director/Physician Advisor referral. Applies...
purposes relative to the RAC audits. 10. Works directly with physician advisor to educate physicians on utilization, medical..., utilization management, or insurance/hospital case management setting. 3. Knowledge of InterQual criteria. 4. Attends...
regulatory documents as provided by CMS. Consults with interdisciplinary team, Physician Advisor and administrative leadership... (2) years acute care nursing experience. One (1) year acute case management or utilization management experience...
requirements. Previous Physician Advisor/Care Management or equivalent experience. Excellent communication skills – both verbal... of Utilization Management is a key member of the healthcare organization’s leadership team and is charged with meeting the...
as a leader of positive change. The Care Management, Care Coordinator, Utilization Management is a member of the healthcare team... for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay...