Physician Advisor
3 weeks ago
Job Summary:
The Physician Advisor will play a critical role in ensuring the appropriate utilization of healthcare resources at Nuvance Health. This position requires a strong clinical background and expertise in assessing medical necessity, utilization review, and admission status assignment.
Key Responsibilities:
- Closely collaborate with case management and attending physicians to review cases for correct status assignment based on medical necessity.
- Perform concurrent peer-to-peer discussions with payer representatives to overturn denials for medical necessity.
- Provide targeted education to providers and staff on correct status assignment and proper chart documentation to prevent denials.
- Assist in denial reduction by identifying trends and improving hospital systems and processes.
Requirements:
- MD/DO degree and a minimum of five years of job-related experience.
- Active unrestrictive CT State Physician/Surgeon license.
- Strong clinical knowledge and ability to apply evidenced-based best practices.
Working Conditions:
This position requires a sedentary/light effort and generally pleasant working conditions.
-
Physician Advisor
3 weeks ago
Danbury, Connecticut, United States Nuvance Health Full timeJob SummaryThe Physician Advisor will develop and maintain expertise in assessing inpatient medical necessity, utilization review, and assignment of appropriate admission status assignment, care progression, as well as both prevention and management of Medicare, Medicaid, Managed Medicare, and commercial concurrent denials of claims of all types. This...
-
Senior Medical Advisor
3 weeks ago
Danbury, Connecticut, United States Nuvance Health Full timeThe Physician Advisor will develop and maintain expertise in assessing inpatient medical necessity, utilization review, and assignment of appropriate admission status assignment, care progression, as well as prevention and management of Medicare, Medicaid, Managed Medicare, and commercial concurrent denials of claims of all types.This includes, but is not...
-
Physician Advisor
3 weeks ago
Danbury, Connecticut, United States Nuvance Health Full timeJob Summary:The Physician Advisor will play a crucial role in ensuring the appropriate utilization of healthcare resources at Nuvance Health. This position requires a strong clinical background and expertise in assessing medical necessity, utilization review, and admission status assignment.Key Responsibilities:Closely collaborate with case management and...
