but saving them. Together. **** MUST HAVE CALIFORNIA LICENSE*** *** Utilization Management Experience*** The Physician..., utilization and case management, or medical staff governance required. Preferred: Experience as a Physician Advisor...
. 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...
, etc.) Job Description: Inova Fairfax Medical Campus is looking for a dedicated physician advisor to join the Utilization Review Advisor team.... This role will be full-time Position. The Utilization Review Advisor (Advisor) position conducts timely and compliant medical...
Center: 99940 - 5421 Utilization Management This position may have a signing bonus available a member of the Recruitment.... The Utilization Management Specialist (UMS) screens patients to determine the appropriate level of care through the use...
Anticipated End Date: 2026-02-06 Position Title: Utilization Management Medical Director – Indiana Medicaid... Job Description: Utilization Management Medical Director – Indiana Medicaid Location: This role enables associates to work virtually full-time...
a successful discharge plan. Works with the UM Manager and Physician Advisor on case reviews for pre-service, concurrent, post-service... are maintained and referred to the Physician Advisor/UM Director. Document in platform/system of record. Utilize designated software...
: Utilization Management services supporting medical necessity and denial prevention Coordinating with payors to authorize... for services from payors Performing accurate medical necessity screening and timely submission for Physician Advisor reviews...
Director of Case Management / Utilization Management / CDI Location: near Gratiot, OH Now is your chance..., Utilization Management, and Clinical Documentation Integrity (CDI). Lead a team of 50–60 Case Managers, UM staff, and CDI...
alternative treatment. Sends letters as needed to prescribing physician(s) and refers to physician advisor as necessary.../utilization management. Skills & Knowledge Knowledge of pharmaceuticals used to treat pain Knowledge of behavioral health...
utilization reviews, physician advisor referrals and other communications related to assigned cases in accordance with department... requirements within the utilization management process. 10. Maintains proficiency in the application of organization selected...
with facility Case Management, Physician Advisor, and Revenue Cycle Team is a requirement. May require travel up to 25% travel...-by-case basis. This position integrates national standards for case management scope of services including: Utilization...
with facility Case Management, Physician Advisor, and Revenue Cycle Team is a requirement. May require travel up to 25% travel...-by-case basis. This position integrates national standards for case management scope of services including: Utilization...
as a leader of positive change. The Utilization Management Coordinator utilizes clinical knowledge and understanding... to ensure appropriate utilization of resources and benefits on a case by case basis. Applies case management and utilization...
/under utilization of services Initiates appropriate referral to physician advisor in a timely manner Understands proper utilization... and communication related to the FCC, payor, physician, physician advisor and in-house care management Second-level physician reviews...
principles of utilization management and serves as a consultant for issues regarding regulations, compliance, payor specific... criteria and the denial management process for the DCH System. Responsibilities: * Supervises utilization review professional...
license. CPUM (certified professional in utilization management), ACM (accredited case manager), or CCM (certified case... and issues to care management physician advisor in compliance with department procedures and follows up as indicated...
Overview: Physician Advisor Palisades Medical Center North Bergen, New Jersey Hackensack Meridian Health... is seeking a collaborative Physician Advisor to join our growing health network. This is an excellent opportunity to become a key...
), the Physician Advisor (PA) will be involved in the following areas: Utilization Management: The Physician Advisor... Job Summary: The Physician Advisor reports to and is accountable to the Vice President Medical Affairs (VPMA) to impact quality...
Regional Physician Advisor supports the Clinical Revenue Cycle’s Utilization Review and Denials/Appeals processes to determine...Sentara Health is seeking to hire a qualified individual to join our team as Regional Physician Advisor. Position...
Regional Physician Advisor supports the Clinical Revenue Cycle’s Utilization Review and Denials/Appeals processes to determine...Sentara Health is seeking to hire a qualified individual to join our team as Regional Physician Advisor. Position...