- Intermountain Health (Albany, NY)
- **Job Description:** Physician will provide Physician Advisor Utilization Reviewer and Central Appeals Work services. Physician shall engage, ... as an expert and local resource to hospital Case Management Department and Medical Staff on issues relating to... Utilization Review ("UR") Committee and provide Regional Physician Advisor Educators information to be shared… more
- Mohawk Valley Health System (Utica, NY)
- …hospitals objectives, and quality patient care while ensuring effective and efficient utilization of resources. The Physician Advisor guides the ... PHYSICIAN ADVISOR Department: CASE MGMT Job...medical/clinical knowledge. + Expertise in, or willing to learn utilization management , state/federal regulations, private payer contracts.… 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
- Wolters Kluwer (New York, NY)
- …efforts, prioritizing efforts and resources for assigned customer portfolio. + **Ongoing Utilization Management ** + Oversee and analyze customer utilization ... Engagement Manager plays a high-impact role in managing strategy and product utilization across the Wolters Kluwer Health's Clinical Decision Support & Provider… 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
- Rochester Regional Health (Rochester, NY)
- …case coordination/patient navigation for patients, including triage management , algorithm management , utilization management and resource management . ... or attending physician to identify cause. Communicates as needed with Physician Advisor , assures patient is placed on clinical pathway and monitors… more
- Rochester Regional Health (Rochester, NY)
- …efficient utilization of resources. Carries out activities related to utilization management , discharge planning, care coordination and referral to other ... + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care...hospital care experience not required. PREFERRED QUALIFICATIONS: + Case Management or Utilization Management experience… more
- Catholic Health Services (Roslyn, NY)
- …compliance with regulatory and external review agencies. + Participates in the Utilization Management Committee, reporting data on utilization trends, ... Overview Director-Care Management Are you exceedingly driven, dedicated, and passionate...resolution of issues. + Refers cases and issues to Physician Advisor in compliance with identified procedures… more
- Nuvance Health (Poughkeepsie, NY)
- …case from physiological and economic perspectives. Has overall accountability for the utilization management and transition management for patients within ... 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… more
- Nuvance Health (Carmel, NY)
- …anticipated discharge plan of care. Escalate deviations from the plan to the Physician Advisor as appropriate. 15. Completes clear and concise documentation of ... quality indicators such as avoidable delays, length of stay, resource utilization , patient satisfaction, patient flow, outlier management , and readmissions… more