705 other physician jobs found

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications. Participates in strategic planning for and evaluation of the Care Management The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Maternal - Fetal Medicine, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the...

Job Description & Requirements Physician Advisor Lead StartDate: ASAP Pay Rate: $280000.00 - $300000.00 Nuvance Health, now a part of Northwell Health, an award-winning non-profit health system, is seeking their next Physician Advisor Lead in Danbury, Connecticut! The Position The Physician Advisor will provide clinical leadership and expertise in utilization management, level-of-care(LOC) determinations, and clinical documentation across the organization. This physician leader will oversee approximately 10+ FTEs (direct and indirect) including two direct physician reports, and will work closely with medical staff, case management, and revenue cycle teams to ensure appropriate utilization of healthcare resources while maintaining high standards of patient care and regulatory compliance. This individual will provide oversight for other physician advisors for both the centralized denial prevention unit and the local hospitals. This role will serve as a key...