- Catholic Health Services (Melville, NY)
- …and standardize the implementation of CM processes and policies, as well as the Physician Advisor role, activities and expectations. + Collaborates with CM and ... to Physician Advisors through annual performance evaluation. + Monitors Physician Advisor performance dashboard with Key Performance Indicators (KPIs). +… 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 the ... care, patient billing status, and potential barriers to patient discharge. The Physician Advisor (PA) conducts clinical review of cases to ensure compliance with… 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 ... physician , nurse or ancillary staff member. Make appropriate referral to physician advisor regarding trends/areas of concern + Proactively monitors patient… more
- 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 ... a home health service, hospice and a network of physician practices across the island. At Catholic Health, our...between the Utilization and Appeals Management Department and the physician of record, as required. + Communicates changes to… 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 ... standardized criteria to justify continued inpatient stay. c. Collaborates with Physician and other clinicians to expedite diagnostic testing, treatment and… more
- Rochester Regional Health (Rochester, NY)
- …length of stay across the continuum + Appropriately identifies and refers cases to the Physician Advisor /E HR in order to validate level of care based on medical ... for improvement. + Actively participates in Education sessions with Utilization Management, Physician Advisors, Coding, and other stake holders in order to grow core… more
- Guthrie (Binghamton, NY)
- …based tools and peer-reviewed journals. 2. Provides clinical denial management assistance to Physician Advisor and denials team. 3. Ensure compliance with all ... Management (UM) in collaboration with Care Coordination, Guthrie Clinic offices, other physician offices, and payers, and the Lourdes Hospital Business Office, is… 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 ... 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… 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 ... appropriate level of care decisions and billing status and ensures compliance with the Utilization Review standard and regulations. Performs concurrent and retrospective utilization management using evidenced-based medical necessity criteria; conducts clinical… 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. ... resource utilization and denials. + Serves as a resource to physicians, physician advisors, CM department, and hospital staff. + Collaborates with all disciplines… 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 ... Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology… 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. ... 9. Provide insurance companies with requested patient information as needed. 10. Maintains a working knowledge of programs necessary for denial management (ie: excel, word, QCPR, Sorian, InterQual, eCW) 11. Maintains files and all letters of non-coverage. 12.… more
- Rochester Regional Health (Rochester, NY)
- …patients across the continuum. + Appropriately identifies and refers cases to the Review Physician Advisor to validate level of care based on medical necessity ... Any physical requirements reported by a prospective employee and/or employee's physician or delegate will be considered for accommodations. PAY RANGE: $33.50… more
- Kaleida Health (Buffalo, NY)
- …as facilitating strong working relationships between HIM, Clinical Documentation, UR, Physician Advisor operations, PFS, Contracting, and hospital departments ... and leadership to promote effective clinical validation improvement and clinical denial management system-wide. Significant influence on system quality and financial outcomes. **Education And Credentials** **Responsibilities:** Bachelor degree in health… more
- Kaleida Health (Buffalo, NY)
- …**Work Type** **: Full-Time** **Shift 1** **Job Description** **Collaborates with the physician advisor team on, but not limited to, clinical documentation ... education, query escalations, and resident training.** **Education And Credentials** **Bachelors Degree and five years of experience in a specialty or lead technician's role of an Advanced Clinical/Biomedical Engineering Department; which services all aspects… more
- The Cigna Group (New York, NY)
- …WILLING TO COMMUTE LOCALLY TO THE OFFICE AND PROVIDERS** The **Provider Contracting Advisor ** serves as an integral member of the Provider Contracting Team and ... hospitals and other providers (eg, Hospital systems, Ancillaries, and large physician groups). + Builds relationships that nurture provider partnerships and seeks… more
- Northwell Health (Lake Success, NY)
- …deadlines, and manage multiple projects effectively. + Experience in physician billing/healthcare operations: Demonstrated experience in medical billing processes, ... coding, or healthcare operations. + Analytical skills with reporting experience: Proven ability to analyze data, interpret reports, and draw meaningful conclusions. + Project management skills: Capability to initiate, plan, execute, and close projects… more
- City of New York (New York, NY)
- …in maintaining inventory of supplies under the direction of the clinic manager or physician -in-charge (PIC). Why you should work for us: - Loan Forgiveness: As a ... prospective employee of the City of New York, you may be eligible for federal/state loan forgiveness and repayment assistance programs that lessen your payments or even fully forgive your full balance. For more information, please visit the US Department of… more
- Cardinal Health (Albany, NY)
- …systems, pharmacies, ambulatory surgery centers, clinical laboratories and physician offices worldwide. The company provides clinically-proven medical products ... and pharmaceuticals and cost-effective solutions that enhance supply chain efficiency from hospital to home. Cardinal Health connects patients, providers, payers, pharmacists and manufacturers for integrated care coordination and better patient management.… more
- Mount Sinai Health System (New York, NY)
- …**This is a hybrid position, requires 3 days onsite/2 days remote** The Physician Relationship Manager III (PRM III) is a senior-level role focused on enhancing ... physician satisfaction, efficiency, and adoption of the Epic Electronic...Epic Electronic Medical Record (EMR) system. As an expert advisor and strategic partner, the PRM III provides high-level… more