• Director Physician Advisor

    Catholic Health Services (Melville, NY)
    …UR department, and presents to Physician Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. ... Initiatives Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC and clinical… more
    Catholic Health Services (03/05/25)
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  • Physician Advisor

    WMCHealth (Valhalla, NY)
    Physician Advisor Company: WMC Advanced Physician Services PC City/State: Valhalla, NY Category: Physicians Department: Clinical Care Mgmt- WMC Health Union: ... (https://pm.healthcaresource.com/cs/wmc1/#/preApply/29449) Internal Applicant link Job Details: Job Summary: The Physician Advisor is responsible for developing positive… more
    WMCHealth (05/22/25)
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  • Physician Advisor

    Mohawk Valley Health System (Utica, NY)
    …level of care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure ... hospitals objectives, and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides the… more
    Mohawk Valley Health System (03/18/25)
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  • Physician Advisor

    Catholic Health Services (West Islip, NY)
    …of hospitalization, LOC status, LOS management, continued stay decisions, clinical review of patients, utilization review activities, resource ... advice, and quality issues. Maintains knowledge of government regulations related to utilization review , transition planning, billing, and managing patients and… more
    Catholic Health Services (03/05/25)
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  • CHS Utilization and Appeals Manager

    Catholic Health Services (Melville, NY)
    …or regulatory timeframes. Collaborates in clinical discussions with the Catholic Health Physician Advisor when appropriate. Reviews results from managed care ... for additional clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician...and level of care to MCC in response to physician order, or review of updated clinical… more
    Catholic Health Services (03/19/25)
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  • Utilization Management RN

    Ellis Medicine (Schenectady, NY)
    …to determine appropriate reimbursement and appropriate status. * Escalates reviews timely to physician advisor timely for lack of medical necessity and/or status ... Basic Function: The Utilization Management Registered Nurse (UM RN) supports daily...and providers. * Effectively communicates with the patient, family, physician and health care team to ensure understanding of… more
    Ellis Medicine (04/03/25)
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  • Case Manager (Inpatient Units)

    Ellis Medicine (Schenectady, NY)
    …of Care and status on all patients through collaboration with Utilization Review RN + Contacts the attending physician for additional information if the ... the Case Manager include, but are not limited to, utilization review , case management, care transition, collaboration...of discharge plan + Collaborates and makes referrals to physician advisor when unable to resolve issues… more
    Ellis Medicine (04/25/25)
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  • RN/Case Manager-MSH-Case Management-FT-Days

    Mount Sinai Health System (New York, NY)
    …Experience Requirements Previous experience as in homecare, long term care or utilization review preferred. Discharge Planner or Case Manager preferred. Manager ... a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...rate. h. Appropriately identifies and refers cases to the physician advisor to support timely progression of… more
    Mount Sinai Health System (04/15/25)
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  • RN/Case Manager-Inpatient-Mount Sinai West-FT-Days…

    Mount Sinai Health System (New York, NY)
    …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... + Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...rate. + Appropriately identifies and refers cases to the physician advisor to support timely progression of… more
    Mount Sinai Health System (05/08/25)
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  • Nurse Navigator - Gynecological Oncology

    Rochester Regional Health (Rochester, NY)
    …soon as possible after admission-within the first 12 to 24 hours. Applies utilization review criteria to assess and document appropriateness of admission, ... documented in the patient chart. Forward patient chart to physician for review when problems are identified....physician to identify cause. Communicates as needed with Physician Advisor , assures patient is placed on… more
    Rochester Regional Health (05/29/25)
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