• Physician Advisor Denials

    CommonSpirit Health (Phoenix, AZ)
    …both inside our hospitals and out in the community. **Responsibilities** 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
    CommonSpirit Health (01/12/25)
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  • Manager - Utilization Review & Denials

    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 ... making a difference in people's lives.** MANAGER,UTILIZATION REVIEW & DENIALS MGMT **Job Description:** Beth Israel Deaconess Hospital-Plymouth recognizes Integrity,… more
    Beth Israel Lahey Health (01/29/25)
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  • Denials Management RN

    Catholic Health Initiatives (Omaha, NE)
    management guidelines, medical necessity criteria, critical thinking skills, and physician advisor review. + Identifies denial root cause for each ... + 5 years of RN experience preferred. + Minimum Three (3) years utilization management experience preferred + Denials management experience preferred. + Care… more
    Catholic Health Initiatives (01/29/25)
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  • Director Clinical and DRG Denials

    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
    Kaleida Health (12/19/24)
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  • Clinical Denials & Appeals Specialist…

    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 ... plus specialized certifications as needed. + Prior experience in Case Management , Utilization Review, and Appeals/ Denials , highly preferred. *Additional Salary… more
    Northwell Health (01/25/25)
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  • Physician Advisor - Utilization…

    Ochsner Health (New Orleans, LA)
    …Come make a difference at Ochsner Health and discover your future today!** The Physician Advisor (PA-Utilization Management ) serves as the physician ... Board of Quality Assurance and Utilization Review Physicians (ABQAURP) or (3) Physician Advisor Sub-Specialty Certification by the American Board of Quality… more
    Ochsner Health (01/29/25)
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  • Physician Advisor - Houston…

    Houston Methodist (The Woodlands, TX)
    …a copy of your CV to Aderonke Adeyeye - physician_###@houstonmethodist.org and reference " Physician Advisor - The Woodlands" in the subject line._** At Houston ... Methodist, the Physician Advisor is responsible for teaching, consulting,...team, in order to assist with the identification and management of denials . Make suggestions related to… more
    Houston Methodist (11/21/24)
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  • Lead Physician Advisor

    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
    Trinity Health (02/01/25)
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  • Physician Advisor

    Dignity Health (Prescott, AZ)
    …www.yrmc.org #hellohumankindness **Responsibilities** **Position Summary:** Reporting to our CMO, the Physician Advisor plays a critical role in promoting ... facility utilization initiatives (ie leverage the leadership influence of Physician Advisor by mobilizing other physicians and...length of stay and reducing avoidable days and claim denials . + Influence physician practices to optimize… more
    Dignity Health (12/11/24)
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  • Physician Advisor - Director…

    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
    Catholic Health Services (11/14/24)
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