Physician Advisor Jobs in Wheeling, WV

Lead transformational initiatives to reduce clinical and technical denials, leveraging analytics and process improvement. Collaborate with stakeholders to create actionable solutions, support recommen...

Unlock new opportunities in healthcare as you build relationships with physicians, drive referrals, and enhance market presence. Collaborate across teams to strategize outreach efforts and improve com...

Reimagine patient care by leveraging clinical expertise to conduct medical reviews, provide peer consultations, and collaborate with a network of physicians, ensuring evidence-based decision-making an...

Join a team that's redefining patient care by leading innovative virtual health initiatives, ensuring quality and safety across a national acute care model, and leveraging AI technologies to improve o...

Drive excellence in quality, risk adjustment, and documentation, integrating critical functions to improve payer performance and financial sustainability in value-based care. Lead a transformative str...

Transform the behavioral health landscape by leading program development, evaluation, and implementation of comprehensive services. Collaborate with experts to ensure compliance and enhance community...

Manage utilization review processes while ensuring adherence to clinical standards. Collaborate with multidisciplinary teams on high-risk cases, support case and disease management, and participate in...

Unlock potential by delivering high-quality utilization management in a collaborative environment. Review escalated cases, advise multidisciplinary teams, and ensure compliance with clinical standards...

Join a dynamic team to extract insights from healthcare data, ensuring alignment with clinical, regulatory, and business goals. Drive data-informed decisions in drug development and patient care strat...

Empower the health plan as a Medical Policy Director, guiding coding and payment policy strategies while collaborating with diverse teams to optimize client solutions and deliver impactful presentatio...

Champion strategic oversight and operational excellence, driving quality, growth, and financial success in healthcare practice operations while collaborating with physician leaders to elevate communit...

Develop and maintain strong physician relationships to enhance referral networks. Conduct assessments to identify strategic opportunities, deliver exceptional service, and execute outreach initiatives...

Support and enhance clinical documentation integrity processes by evaluating reviews and compliance. Collaborate with the CDI team to provide coaching, develop educational resources, and deliver insig...

Elevate healthcare outcomes by utilizing your expertise as a DRG Downgrade Appeals Clinician, performing clinical reviews and crafting compelling appeal documentation to support medical necessity and...

Innovate patient care as you educate and support patients and caregivers through the therapy access process, ensuring timely access to essential treatments while managing relationships and collaborati...

Investigate and adjust complex MPL and General Liability claims. Collaborate with insureds and stakeholders, develop negotiation strategies, and ensure timely documentation while maintaining strong co...

Champion revenue growth by owning complex sales opportunities and strategic account planning within a defined territory, leveraging consultative selling to drive customer outcomes and elevate executiv...

Unlock potential by managing compliance and quality assurance in behavioral health programs. Lead operational strategies, interpret policies, and collaborate with regulators to maintain high standards...

Elevate analytics capabilities by leading innovative data projects in finance, utilizing advanced visualization tools and methodologies to drive impactful reporting solutions that support decision-mak...

Engage in high-level EHR implementations for health systems, driving success from design to sustained adoption. This director-level role focuses on executive relationships, delivery excellence, and op...

Shape the future of healthcare by leveraging your clinical expertise to conduct evidence-based case reviews and collaborate with physicians to ensure optimal patient care...

Unlock potential by leading medical management initiatives remotely, supporting member needs and optimizing clinical services for optimal care. Leverage your expertise in Orthopedic Spine or Neurosurg...

Explore the complexities of coding for surgical and complex specialties by providing education, support, and documentation feedback. Collaborate across departments to optimize workflows and ensure com...

Elevate community emergency medicine by practicing in diverse settings across the North Region. Collaborate with over 100 professionals to provide exemplary care while teaching and mentoring the next...

Pioneer the optimization of inpatient clinical applications, collaborating with end-users and operational leaders to enhance workflows and support Epic EHR systems. Drive impactful communication and a...