Teams at St. Joseph's Health

Provide outpatient and inpatient pediatric clinical care, supervise nursing staff, maintain regulatory documentation, offer on-call coverage, teach and supervise trainees, engage in scholarly activity, participate in quality and safety initiatives, and perform administrative duties as assigned.

Partner with physicians, care management, and hospital leadership to conduct medical necessity and utilization reviews, determine patient status, manage denials and appeals, educate providers, and improve throughput and length-of-stay while ensuring CMS and payer compliance.

Provide physician-led utilization management and case review to ensure medical necessity, reduce denials, manage appeals, support throughput/length-of-stay initiatives, educate providers, collaborate with care management and leadership, and ensure regulatory compliance.