Physician Advisor
4 days ago
Provides clinical expertise and guidance to Clinical Analysis and appeals team. Acts as the physician advisor for medical necessity appeals and for the Pennsylvania Medical assistance (PAMA) utilization reviews. Acts as a physician resource for the regulatory and revenue cycle denial and appeals processes for hospital activity, including utilization review for all PAMA cases, all UM denials and appeals.EducationDoctorate Degree : Medicine or Osteopathic Medicine (Required)ExperienceGeneral Experience and strong working knowledge of the Interqual Criteria Set and hospital reimbursement systems (Required)General Experience in a role dealing with Second and Third level appeals processes including direct experience with being an expert witness (Required)General Experience in a managed care environment (Required)General Experience in an Administrative Leadership role (Preferred)License/CertificationsMD-LIC - PA Medical Physician License (Required) or DO-LIC - PA Osteopathic Physician (Required)Your Tomorrow is HereTemple Health is a dynamic network of outstanding hospitals, specialty centers, and physician practices that is advancing the fight against disease, pushing the boundaries of medical science, and educating future healthcare professionals. Temple Health consists of Temple University Hospital (TUH), Fox Chase Cancer Center, TUH-Jeanes Campus, TUH-Episcopal Campus, TUH-Northeastern Campus, Temple Physicians, Inc., and Temple Transport Team. Temple Health is proudly affiliated with the Lewis Katz School of Medicine at Temple University.To support this mission, Temple Health is continuously recruiting top talent to join its diverse, 10,000 strong workforce that fosters a healthy, safe and productive environment for its patients, visitors, students and colleagues alike. At Temple Health, your tomorrow is hereEqual Opportunity Employer/Veterans/DisabledAn Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.Your Tomorrow is HereTemple University Hospital is a nationally respected teaching hospital on Temple University's bustling Health Sciences Center campus. The hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner, across the country and around the world. As the chief clinical training site for the Lewis Katz School of Medicine at Temple University, the hospital provides a dynamic environment for high-quality care, teaching, and cutting edge research.
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Physician Advisor
4 days ago
Philadelphia, United States Pennsylvania Medicine Full timePenn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.Today at Penn...
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Physician Advisor
2 weeks ago
Philadelphia, United States Pennsylvania Medicine Full timePenn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn...
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Physician Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob Title: Physician AdvisorCommunity Behavioral Health is seeking a highly skilled Physician Advisor to join our team. As a Physician Advisor, you will play a critical role in providing clinical leadership and oversight of the clinical management of our members.Key Responsibilities:Provide consultation on overall quality of care, medical decision making,...
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Physician Advisor
2 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob Title: Physician AdvisorThe Physician Advisor is a critical role at Community Behavioral Health, responsible for providing clinical leadership and oversight of the clinical management of members. This position requires a strong understanding of clinical best practices, as well as the ability to communicate effectively with healthcare providers and...
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Physician Advisor
2 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob Title: Physician AdvisorCommunity Behavioral Health is seeking a highly skilled Physician Advisor to provide clinical leadership and oversight of the clinical management of members. The ideal candidate will have a strong background in psychiatry and experience in inpatient care and substance abuse treatment.Key Responsibilities:Provide consultation on...
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Physician Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health Full timeJob SummaryWe are seeking a highly skilled Physician Advisor to join our team at Community Behavioral Health. As a key member of our medical affairs team, you will provide clinical leadership and oversight to ensure the highest quality of care for our members.Key ResponsibilitiesProvide clinical consultation and guidance to healthcare providers and...
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Physician Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob SummaryWe are seeking a highly skilled Physician Advisor to join our team at Community Behavioral Health. As a key member of our clinical leadership team, you will be responsible for providing expert clinical guidance and oversight to ensure the highest quality of care for our members.Key ResponsibilitiesProvide clinical leadership and oversight to...
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Physician Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob SummaryWe are seeking a highly skilled Physician Advisor to join our team at Community Behavioral Health. As a key member of our clinical leadership team, you will be responsible for providing expert clinical guidance and oversight to ensure the highest quality of care for our members.Key ResponsibilitiesProvide clinical leadership and oversight to...
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Physician Advisor
2 weeks ago
Philadelphia, Pennsylvania, United States Penn Medicine Full timeJob SummaryThe Physician Advisor is a key member of the healthcare organization's leadership team, responsible for ensuring the effective and efficient utilization of healthcare services. This role requires a physician with expertise in clinical practice patterns, resource utilization, medical necessity, and compliance with governmental and private payer...
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Physician Advisor
2 weeks ago
Philadelphia, Pennsylvania, United States Pennsylvania Medicine Full timeJob SummaryPenn Medicine is seeking a highly skilled Physician Advisor to join our team. As a key member of our leadership team, you will be responsible for ensuring the effective and efficient utilization of healthcare services. You will work closely with medical staff leadership, case management, and all areas of resource management to develop and...
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Physician Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob SummaryWe are seeking a highly skilled Physician Advisor to join our team at Community Behavioral Health. As a key member of our clinical leadership team, you will play a critical role in providing clinical oversight and guidance to ensure the highest quality of care for our members.Key ResponsibilitiesProvide clinical leadership and oversight to ensure...
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Physician Advisor
4 weeks ago
Philadelphia, United States Community Behavioral Health. Full timeJob DescriptionJob DescriptionThe Physician Advisor is responsible for providing clinical leadership through oversight of the clinical management of members. The Physician Advisor provides consultation regarding overall quality of care, medical decision making, case formulations, medication and other safety concerns, specific to case review and levels of...
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Physician Advisor
3 weeks ago
Philadelphia, United States Community Behavioral Health. Full timeJob DescriptionJob DescriptionThe Physician Advisor is responsible for providing clinical leadership through oversight of the clinical management of members. The Physician Advisor provides consultation regarding overall quality of care, medical decision making, case formulations, medication and other safety concerns, specific to case review and levels of...
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Clinical Expert Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Temple University Full timePhysician Advisor Job DescriptionTemple Health seeks a skilled Physician Advisor to provide clinical expertise and guidance to our Clinical Analysis and appeals team. As a key member of our team, you will act as a physician advisor for medical necessity appeals and for the Pennsylvania Medical Assistance (PAMA) utilization reviews.Key...
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Physician Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob SummaryWe are seeking a highly skilled Physician Advisor to join our team at Community Behavioral Health. As a key member of our clinical leadership team, you will be responsible for providing expert clinical guidance and oversight to ensure the highest quality of care for our members.Key ResponsibilitiesProvide clinical leadership and oversight to...
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Physician Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob SummaryWe are seeking a highly skilled Physician Advisor to join our team at Community Behavioral Health. As a key member of our clinical leadership team, you will play a critical role in providing clinical oversight and guidance to our care management team.Key ResponsibilitiesProvide clinical leadership and oversight to ensure high-quality care for our...
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Physician Advisor
3 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob SummaryWe are seeking a highly skilled Physician Advisor to join our team at Community Behavioral Health. As a key member of our clinical leadership team, you will be responsible for providing expert clinical guidance and oversight to ensure the highest quality of care for our members.Key ResponsibilitiesProvide clinical leadership and oversight to...
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Physician Advisor
4 weeks ago
Philadelphia, Pennsylvania, United States Community Behavioral Health. Full timeJob SummaryWe are seeking a highly skilled Physician Advisor to join our team at Community Behavioral Health. As a key member of our clinical leadership team, you will be responsible for providing expert clinical guidance and oversight to ensure the highest quality of care for our members.Key ResponsibilitiesProvide clinical leadership and oversight to...
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Physician Advisor
4 weeks ago
Philadelphia, PA, United States Community Behavioral Health. Full timeThe Physician Advisor provides consultation regarding overall quality of care, medical decision making, case formulations, medication and other safety concerns, specific to case review and levels of care or cohort. Community Behavioral Health offers a very competitive compensation and benefits package, including: ~ 403B Retirement Plan ~ Employee...
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Physician Advisor
1 week ago
New Philadelphia, Pennsylvania, United States Community Behavioral Health Full timeJob SummaryThe Physician Advisor is a key member of our clinical leadership team, responsible for providing expert guidance on clinical management and quality of care for our members. This role requires a strong understanding of medical decision-making, case formulations, and medication safety concerns.Key ResponsibilitiesProvide clinical leadership and...
