- 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
- 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
- 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. + ... 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
- Rochester Regional Health (Rochester, NY)
- …as soon as possible after admission-within the first12 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 (Rochester, NY)
- …stay of patients across the continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on medical ... necessity in the Care Management Data base to support the clinical review process. + Concurrently monitors resources utilization , performing continued stay… more
- 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 ... Responsibility + Serves as liaison between the patient and facility/ physician and the third party payer. + Prepares and...decisions and billing status and ensures compliance with the Utilization Review standard and regulations. + Performs… 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. ... staff satisfaction. + Assures compliance with regulatory and external review agencies. + Participates in the Utilization ...and denials. + Serves as a resource to physicians, physician advisors, CM department, and hospital staff. + Collaborates… 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 ... level of care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. Performs concurrent and retrospective … more