for utilization review case management and appeals for local Commercial business in the CO, OH, IN, KY, MO, and WI markets. May... and serve as clinical/strategic advisor to enhance clinical operations. May identify cost of care opportunities. May serve...
Minimum of 2 years UR/Case Management experience preferred Managed care payor experience a plus either in Utilization Review... Manager (CCM) or Certified Professional in Utilization Review/Utilization Management/Healthcare Management (CPUR , CPUM...
interdisciplinary care management rounds. Ensures collaboration between multidisciplinary healthcare team members, primary physician... or continued stay is not clear. Consults with the Physician Advisor when the admission or continued stay does not meet criteria...
documentation for both inpatient and outpatient encounters. **Partners with coding, Utilization Management and the Physician Advisor... for services rendered. Builds and maintains collaborative relationships with internal teams, external consultants, and physician...
PET Amyloid space and be a trusted advisor to help customers navigate new amyloid PET imaging marketplace Understand..., referring physicians, and pharmacy partners). Understand and leverage the value of providing referring physician education...
interdisciplinary care management rounds. Ensures collaboration between multidisciplinary healthcare team members, primary physician... or continued stay is not clear. Consults with the Physician Advisor when the admission or continued stay does not meet criteria...
resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. Responsible for hiring.... Plans, coordinates and acts as the liaison for patient care as per the disease management agreement, including initial...
coordination, discharge planning and utilization management (UM) activities. Collaborates with managers, physicians, medical...’s plan of care. Refers cases to physician advisor as needed to ensure efficient progression of care, accurate status...
management protocols in conjunction with the Wound Care Nurse RN, physician advisor, and/or Lead Physician Committee Identifies... with the physician advisor to the program, the Wound Care Nurse RN, and attending physicians who frequently act as the...
resolution. Acts as an advisor to subordinate(s) to meet schedules and/or resolve technical problems. Responsible for hiring.... Plans, coordinates and acts as the liaison for patient care as per the disease management agreement, including initial...
review/management expertise Expanded credentials as an expert in Independent Medical Exams and physician advisor services...Requirements: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise...
Care Guidelines (MCG), etc. Collaborates with the Attending of record and the Physician Advisor as indicated for review... to obtain certification of the patient days and secure reimbursement. Confers with Attending Physician, Physician Advisor...
retrospective query rates and discuss questions related to Coding and CDI Engages and consults with Physician Advisor / VPMA when... with best-practice adoption methodology and change management support, is helping hospitals make a real impact on CDI efficiency...
retrospective query rates and discuss questions related to Coding and CDI Engages and consults with Physician Advisor / VPMA when... with best-practice adoption methodology and change management support, is helping hospitals make a real impact on CDI efficiency...
management protocols in conjunction with the Wound Care Nurse RN, physician advisor, and/or Lead Physician Committee Identifies... with the physician advisor to the program, the Wound Care Nurse RN, and attending physicians who frequently act as the...
. More about our team Accountable for the execution, adaptation and outcome of care management as prescribed in the initial Utilization... appropriate level-of-care placement. • Uses EMR and MCG Criteria for utilization management and quality screening. • Identifies...
role in concurrent denial process. Works with Care Management Director, Physician Advisor, Attending Physicians.... The Care Manager (CM) coordinates the clinical and financial plan for patients. Performs overall utilization management...
development, implementation, and evaluation of department and physician advisor goals. Role models professional standards... growth, mastering essential skills such as peritoneal dialysis, time management, and delivering compassionate patient care...
be a part of our INTEGRIS Health Southwest Medical Center Case Management team providing exceptional work supporting the..., coordinating and monitoring resource utilization to achieve optimal clinical outcomes and financial goals. The Case Manager...
integrates national standards for case management scope of services including: Utilization Management supporting medical... include the following activities: a) accurate medical necessity screening and submission for Physician Advisor review, b) care...