
Copa Health
Case manager lead
Who We Are At Copa Health, we are committed to People First, fostering a culture of compassion, innovation, and impact. We support individuals and families across Arizona through high-quality...

Location
onsite, Phoenix, AZ, United States
Commitment
Full Time
Level
Senior (5+ years)
Hello Humankindness: Join a Legacy of Healing at Saint Joseph’s Hospital and Medical Center (SJHMC)
Ready to make a real difference? Join SJHMC in Phoenix AZ., a 571-bed nonprofit founded by the Sisters of Mercy over 125 years ago. We're more than a hospital; we're a global destination for life-changing care, embracing patients with humankindness.
Here, your calling will flourish. We're not just a workplace; we're a community dedicated to a mission of service.
This is an invitation to join a family of dedicated professionals at the forefront of medical innovation, united by the power of humankindness.
As our Physician Advisor, you will promote evidence-based medical care and appropriate hospital resource utilization, facilitating communication across medical, nursing, care coordination, and administrative departments.
Every day you will advocate for efficient patient care, remove barriers, and collaborate with attending physicians, bolstering the Department of Care Coordination's utilization and compliance efforts.
To be successful, you need exceptional clinical acumen, strong communication, and a deep understanding of hospital operations/regulations. Your ability to influence, drive efficiency, and advocate will be paramount for optimizing care and resource allocation.
Mitigate denials for payment from insurance payers by providing valid and effective secondary medical necessity reviews. Review and report performance measures and make recommendations to Departments and the Medical Executive Committee regarding opportunities for improvement of patient care, resource utilization, billing compliance and reduction of claims denials.
Provide a compliance element for Centers for Medicare and Medicaid Services (CMS) Conditions of Participation (COP) by performing secondary medical necessity reviews.
Provide a more cost-effective delivery of secondary medical necessity reviews than what is currently provided by outside contracted services (Executive Health Resources (EHR).
Align and collaborate with the facility leadership.
Understand and appreciate unique elements of facility history and culture in order to effectively execute/implement job duties and functions.

Copa Health
Who We Are At Copa Health, we are committed to People First, fostering a culture of compassion, innovation, and impact. We support individuals and families across Arizona through high-quality...

Avery's House LLC
Job Duties: Provide individual, family and group sessions. Provide leadership and management in the clinical area in order to serve as a role model for staff and clients. Maintain healthy,...

Accenture
Accenture helps the world's leading enterprises reinvent by building their digital core and unleashing the power of AI to create value at speed for organizations across industries. Our strategy is to...

FSL Programs
Position Summary Under the supervision of the Executive Support Manager, the Office Manager provides administrative support for all AGL programs. This position collects and manages departmental data,...

Team Select Home Care
The Healthcare Coordinator supports the operational management of an assigned patient caseload by coordinating scheduling, processing payroll, and supporting day-to-day branch functions. This role...

Turner & Townsend
Company Description Turner & Townsend is a global professional services company with over 22,000 people in more than 60 countries. Working with our clients across real estate, infrastructure, energy...

Specialty Dental Brands
Premier Orthodontics is seeking a skilled and passionate Patient Care Coordinator to join our well-established team. With a strong reputation for exceptional patient care and cutting-edge treatment...