- Northwell Health (Melville, NY)
- …level of care and medical necessity for assigned case. + Collaborates with physician advisor , payor representative and site case managers to facilitate ... coding issues and knowledge gaps. Job Responsibility + Serves as liaison between the patient and facility/ physician and the third party payer. + Prepares and defends… more
- Northwell Health (Melville, NY)
- …defends level of care and medical necessity for assigned case. Collaborates with physician advisor , payor representative and site case managers to facilitate ... Review standard and regulations. Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts clinical reviews… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MGMT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level ... of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance… more
- Catholic Health Services (Roslyn, NY)
- …skills to ensure timely resolution of issues. + Refers cases and issues to Physician Advisor in compliance with identified procedures and follow-up as indicated. ... Overview Director-Care Management Are you exceedingly driven, dedicated, and passionate...denials . + Serves as a resource to physicians, physician advisors, CM department, and hospital staff. + Collaborates… more
- Rochester Regional Health (Rochester, NY)
- …patients across the continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on medical necessity ... Job Title: Care Facilitator Department: Case Management Location: Canton-Potsdam Hospital with floating to other...plan of care. + Performs retrospective reviews on insurance denials and assists in appeal process. + Participates in… more
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