- Catholic Health Services (Melville, NY)
- …and presents to Physician Advisors during the monthly Physician Advisor meeting. Attends hospital Utilization Management (UM) committees. Supervises ... an educational program. Collaborates with management in recruiting new Catholic Health Physician Advisor hires. Trains new Physician Advisor hires.… more
- WMCHealth (Valhalla, NY)
- …duties as assigned. Qualifications/Requirements: Experience: Experience as a CDI champion and/or Case management Physician Advisor or having 3-5 years as a ... Physician Advisor Company: WMC Advanced ...ensuring physician support and execution of for Utilization Management and Documentation strategies and processes.… more
- Mohawk Valley Health System (Utica, NY)
- PHYSICIAN ADVISOR Department: CASE MANAGEMENT Job Summary The Physician Advisor collaborates with Care Managers and Attending Physicians to align on ... hospitals objectives, and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides the… more
- Guidehouse (New York, NY)
- …by utilization of the relevant guidelines and appropriate referrals to the physician advisor and the UR Committee + Identifies, develops and implements ... inpatient level of care or observation services based on physician certification + Gathers clinical information to conduct continued...License - REQUIRED + 4+ years of experience in utilization management + Familiarity with MCG and… more
- Catholic Health Services (Melville, NY)
- …clinical documentation. Acts as liaison between the Utilization and Appeals Management Department and the physician of record, as required. Communicates ... or regulatory timeframes. Collaborates in clinical discussions with the Catholic Health Physician Advisor when appropriate. Reviews results from managed care… more
- Mount Sinai Health System (New York, NY)
- …to reduce readmission rate. h. Appropriately identifies and refers cases to the physician advisor to support timely progression of patients along the continuum ... are not limited to: a Reviews all new admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using… more
- Arnot Health (Elmira, NY)
- … of patient care. The Case Manager will review all patients for utilization management and appropriate discharge planning. The Case Manager's average caseload ... practice. The Case Manager will work cooperatively with the Physician Advisor and Team. DUTIES AND RESPONSIBILITIES:...nursing in acute care hospital setting or two years utilization management in an acute care hospital… more
- Ellis Medicine (Schenectady, NY)
- …prior to implementation of discharge plan + Collaborates and makes referrals to physician advisor when unable to resolve issues with attending physician ... Services discharge planning guidelines and departmental/organizational policies and processes + Utilization Management : + Ensures order in chart/EMR coincides… more
- Mount Sinai Health System (New York, NY)
- …NYSNA-SLW NYSNA at Mount Sinai St. Luke's and Mount Sinai West, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** 1. Principle Duties and ... 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
- Arnot Health (Elmira, NY)
- …in matters of auth/denial review decisions. 8. Maintains a working relationship with Physician Advisor regarding physician issues related to auths/denials. ... $10,000 Sign on Bonus for qualified Case Managers! MAIN FUNCTION: The Case Management (denial/prior auth) will review and appeal as appropriate for concurrent and… more