- Trinity Health (Athens, GA)
- …Improvement activities. To compile data and assist with maintaining Physician profiles. **II. Position Requirements** : **A: Licensure/Certification/Registration** : ... Current Georgia Registered Nursing License. **B. Education:** Graduate of an accredited school of nursing. Bachelor's degree preferred. **C: Experience:** Three to five years recent clinical experience in an acute care hospital. **D. Special Qualifications:**… more
- AdventHealth (Calhoun, GA)
- …which may also result in the need for FPPE. Maintains databases of physician peer review credentialing/re-credentialing, and quality improvement activities ... review of cases meeting established indicators, preparation of case summaries for physician review ...Distributes request for FPPE review to applicable Physician Peer Review Representatives. +… more
- Trinity Health (Boise, ID)
- …data used in consideration for appointment/reappointment. Maintain and coordinate the entire Physician Peer Review process regarding information control and ... of care. **We are seeking to hire a temporary Peer Review Coordinator!** As a Peer...direct one-on-one communication. Analyze data regarding current and past case reviews and subsequent requested reports, and integration of… more
- WellSpan Health (Lebanon, PA)
- Certified Peer Specialist Senior - Community Peer Support - Days Location: WellSpan Philhaven, Lebanon, PA Schedule: Part Time General Summary Facilitates ... Essential Functions: + Draws on common experiences as a peer to provide guidance and encouragement to patients to...and preference regarding medications, under the direction of the physician and nursing staff. + Promotes participation in Wellness… more
- WellSpan Health (York, PA)
- …of level of care and verify need for peer to peer review -discuss with the CM nurse and/or attending physician as needed and then document activities. ... Physician Advisor Location: WellSpan Medical Group, York, PA...medicine. Required + Less than 1 year Experience with peer review and/or case management.… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and HackensackUMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and transitions ... **Overview** The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity… more
- Baptist Memorial (Memphis, TN)
- …admission review against standard criteria per payer guidelines + Prioritizes observation case review + Assists with level of care in collaboration with ... education + Employee referral program Job Summary: Position: 19738 - RN-Utilization Review Facility: BMHCC Corporate Office Department: HS Case Mgmt… more
- WMCHealth (Valhalla, NY)
- …with a third party leveling and/or appeals agency preferred. Previous utilization management, case management or peer review documentation experience in ... + Provides clinical rational for standard and expedited appeals. + Participate in peer -to- peer review with payors and/or complete appeals as required… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the ... billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of...reimbursement models in decision making and reviews. + Provide peer -to- peer payor review in collaboration… more
- CommonSpirit Health (Sacramento, CA)
- …**Responsibilities** **This is a remote position.** **Summary** The Utilization Management Physician Advisor II conducts clinical case reviews referred by ... be a part of the specialized Denials Management team. This individual meets with case management and health care team members to discuss selected cases and make… more