- Catholic Health Services (Melville, NY)
- …and presents to Physician Advisors during the monthly Physician Advisor meeting. + Attends hospital Utilization Management (UM) committees. + Supervises ... Maintains knowledge of regulatory and accreditation requirements related to utilization review (UR), discharge planning (DP), LOC...of CM processes and policies, as well as the Physician Advisor role, activities and expectations. +… more
- 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
- Catholic Health Services (Melville, NY)
- …Manage Care Payors or regulatory agencies, as needed or requested. + Manages physician advisor reports and assists with facilitating UM Committee reviews when ... timely follow through. + Reviews providers' requests for services and coordinates utilization /appeals management review . + Assist Utilization and Appeals… 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. 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
- 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
- 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
- Nuvance Health (Poughkeepsie, NY)
- …and at a minimum the case manager reviews observation cases daily. 3. Utilizes physician advisor to interface with physicians as needed. 4. Collaborates with the ... Nursing, BSN preferred. Must have current RN license. *Preferred Experience: * Utilization Review /Management.Company: Vassar Brothers Medical Center Org Unit:… more
- Catholic Health Services (Melville, NY)
- …hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the ... The Professional Fee (ProFee) Clinical Documentation Specialist (CDS) will serve as an advisor and expert resource for providers to improve the accuracy of clinical… more
- Kaleida Health (Buffalo, NY)
- …as facilitating strong working relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments ... and insurance / managed care practices including but not limited to: utilization review , RAC, MAC, Q10, clinical and DRG denial management required. **Working… more