• 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 (06/27/25)
    - Related Jobs
  • 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)
    - Related Jobs
  • 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 (07/09/25)
    - Related Jobs
  • 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 (07/24/25)
    - Related Jobs
  • Utilization Management RN

    Guidehouse (New York, NY)
    …on physician certification + Gathers clinical information to conduct continued stay utilization review activities with payers on a daily basis + Performs ... None **What You Will Do** **:** + Performs chart review of identified patients to identify quality, timeliness and...of the relevant guidelines and appropriate referrals to the physician advisor and the UR Committee +… more
    Guidehouse (07/25/25)
    - Related Jobs
  • Case Manager , RN (FH)

    Northwell Health (Forest Hills, NY)
    …of stay.Discusses with attending physician and/or physician advisor the appropriateness of resource utilization , consultation and treatment ... established criteria.Discusses with attending physician and/or physician advisor the appropriateness of resource utilization , consultation and treatment… more
    Northwell Health (08/16/25)
    - Related Jobs
  • 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 (07/25/25)
    - Related Jobs
  • 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. ... 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 (07/15/25)
    - Related Jobs
  • 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. + ... 1. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management...rate. 8. Appropriately identifies and refers cases to the physician advisor to support timely progression of… more
    Mount Sinai Health System (08/16/25)
    - Related Jobs
  • Care Facilitator- Per Diem- Canton-Potsdam…

    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
    Rochester Regional Health (07/25/25)
    - Related Jobs