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...
. Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow... of experience in care management or utilization review required 1-3 years of leadership experience in a healthcare setting...
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...
Position Overview: The Physician Advisor (PA) is a key member of the hospital's leadership team charged with meeting the... expertise on matters regarding physician practice patterns, over- and under-utilization of resources, medical necessity...
Position Overview: The Physician Advisor (PA) is a key member of the hospital's leadership team charged with meeting the... expertise on matters regarding physician practice patterns, over- and under-utilization of resources, 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...
health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Utilization Management... and provide high quality reviews. The First Level Review Nurse will perform their job functions, adhering to Optum Physician...
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...
Job Description: Overview The Utilization Management (UM) RN is responsible to facilitate care along a continuum... summarizes and refers cases not meeting criteria to Physician Advisor. Applies regulatory requirements and policy concerning...
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...
utilization management referral process for LOS data and physician profile database. Collaborates with the unit medical director...Utilization Management Nurse - Christiana Hospital FT Day Shift (Hours.: 8 AM - 4:30 PM) Newark...
PKWY, Daytona Beach, 32117 The role youll contribute: The role of the Utilization Management (UM) Registered Nurse (RN... is indicated, the UM nurse is responsible for escalation to the Physician Advisor or designated leader for additional review...
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...
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...
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...
through the continuum while facilitating the functions of utilization review, utilization management, and cost containment... are indicated by clinical review. Identify cases needed for second level of review- refers cases to the Physician Advisor...
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...