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Utilization Review Physician - Einstein Montgomery, Jefferson Health
Philadelphia, Pennsylvania, United States
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Job Summary

Occupation Physician
Specialty Occupational Medicine
Degree Required MD/DO
Position Type Permanent/Full-Time
Work Environment Hospital Clinic/Private Practice
Location 19403, Jefferson, Pennsylvania, United States
Visa Sponsorship No

Job Description

Last Update: 4/11/24

Einstein Medical Center Montgomery, now a part of Jefferson Health, is seeking a Physician for a full-time Utilization Review position. This position is responsible for chart review along with Case Management Staff and Medical Staff education, and completing Peer to Peer appeals with insurance companies. This position will be primarily onsite with potential for some remote capabilities.

Additional Details:

The position collaborates closely with the 5 department UR nurses. The UR Physician will work with any attending or resident or any case as needed. They will also be involved in educating the resident and medical staff of documentation and medical necessity for both Severity of Illness and Intensity of Service to meet our clinical criteria guidelines for InterQual.

  • Must have PA license
  • Previous UR experience strongly preferred

Jefferson includes Thomas Jefferson University and Jefferson Health, a dynamic university and health system with broad reach across the Delaware Valley. Jefferson is the second largest employer in Philadelphia and the largest health system in Philadelphia based on total licensed beds.

Through the merger of Thomas Jefferson University and Philadelphia University in 2017, our University includes ten colleges and four schools. We are an NCAA Division II university and an R2 national doctoral university offering undergraduate and graduate-level programs that provide students with a forward-thinking education in architecture, business, design, engineering, fashion and textiles, health, medicine and social science.

Jefferson Health, the clinical arm of Thomas Jefferson University, has grown from a three-hospital academic health center in 2015, to an 18-hospital health system through mergers and combinations that include hospitals at Abington Health, Aria Health, Kennedy Health, Magee Rehabilitation and Einstein Healthcare Network. We have over 50 outpatient and urgent care centers; ten Magnet®-designated hospitals (recognized by the ANCC for nursing excellence); the NCI-designated Sidney Kimmel Cancer Center (one of only 70 in the country and one of only two in the region); and one of the largest faculty-based telehealth networks in the country. In 2021, Jefferson Health became the sole owner of HealthPartners Plan, a not-for-profit health maintenance organization in Southeastern Pennsylvania. We are the first health system regionally to create an aligned payer-provider partnership.

Jefferson’s mission, vision and values create an organization that attracts the best and the brightest students, faculty, staff, and healthcare professionals, as well as the most visionary leaders to drive exceptional results.

  • OUR MISSION: We improve lives.
  • OUR VISION: Reimagining health, education and discovery to create unparalleled value
  • OUR VALUES: Put People First, Be Bold & Think Differently and Do the Right Thing

As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.