and drive increased utilization over time. Serve as a subject matter expert, speaking with clinicians of all levels... advisor' relationship and establish oneself as fully accountable for demonstrating ROI to the partner account, ensuring...
request. This position is primarily responsible for Utilization Management, including prior authorization and precertification... or experience as a Physician Advisor or working for an Independent Review Organization a Plus + Preferred Qualifications...
screening and submission for Physician Advisor review o Care coordination that includes admitting diagnosis/ medical history... to Utilization Management Plan. Integrates National standards for care management scope of services including: o Utilization...
screening and submission for Physician Advisor review o Care coordination that includes admitting diagnosis/ medical history... to Utilization Management Plan. Integrates National standards for care management scope of services including: o Utilization...
Care Services. The CM Service is comprised of three departments: Case Management, Utilization Management, and Social Work...) Next Steps: If selected to move forward with Interview Process, a Talent Advisor will contact you via email for a screen...
for case management scope of services including: Utilization Management supporting medical necessity and denial prevention...: a) accurate medical necessity screening and submission for Physician Advisor review, b) care coordination, c) transition planning...
of care. Collaborates with Physician Advisor for complex issues related to the medical plan of care. Actively participates... of Maryland. Three years of experience in an acute care hospital. Experience in case management and/or utilization management...
of care. Collaborates with Physician Advisor for complex issues related to the medical plan of care. Actively participates... of Maryland. Three years of experience in an acute care hospital. Experience in case management and/or utilization management...
, to management, Physician Advisor, Complex Care team and/or Ethics committee. It is the role of the SW CM to educate patients... an impression which reflects favorably upon the organization. In collaboration with Utilization Review, the SW CM will initiate...
worker intervention Need for external case management intervention Education Actively influences physician practice... for physician advisor intervention and facilitates same Completes Hospital Issued Notice of Noncoverage (HINN) processes Maintains...
for case management scope of services including: Utilization Management supporting medical necessity and denial prevention...: Accurate medical necessity screening and submission for Physician Advisor review Care coordination Transition planning...
and physician advisor, (i) collaboration with the healthcare team including physicians, office staff, ancillary departments... resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources...
in a timely manner Collaborates with Utilization Management and synthesizes information in order to reduce avoidable days... Collaborates with Physician Advisor for complex issues Guides physicians in appropriate clinical documentation Actively...
utilization over time. Serve as a subject matter expert, speaking with clinicians of all levels regarding the science... across multiple stakeholders among both prospective and existing partners. Develop a 'trusted advisor' relationship and establish...
in a timely manner Collaborates with Utilization Management and synthesizes information in order to reduce avoidable days... Collaborates with Physician Advisor for complex issues Guides physicians in appropriate clinical documentation Actively...
management/utilization review and discharge planning collaboratively determining level of care needs beyond acute care, providing... as appropriate. Coordinates the hospital activities concerned with case management/utilization review and discharge planning. Adheres...
necessity screening and submission for Physician Advisor review o Care coordination that includes admitting diagnosis/ medical... to Utilization Management Plan. Integrates National standards for care management scope of services including: o Utilization...
necessity screening and submission for Physician Advisor review o Care coordination that includes admitting diagnosis/ medical... to Utilization Management Plan. Integrates National standards for care management scope of services including: o Utilization...
appropriate for secondary review to Case Management Department leadership, the Medical Director, or Physician Advisor.... Resource Management; Assures prudent utilization of all resources (fiscal, human, environmental, equipment and services...
appropriate for secondary review to Case Management Department leadership, the Medical Director, or Physician Advisor.... Resource Management; Assures prudent utilization of all resources (fiscal, human, environmental, equipment and services...