- 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 CDI ... 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
- Catholic Health Services (West Islip, NY)
- …peer-to-peer calls and advise on continued stay reviews that require additional Physician Advisor input. Knowledge of appeals process and necessary documentation ... experience as a member of the UM oversight committee or past Physician Advisor experience preferred. Ability to travel to the various Catholic Health locations.… more
- Northwell Health (Bay Shore, NY)
- …on all patients and share all problematic cases with the Supervisor and Physician Advisor . + * Determines and makes appropriate referrals concerning alternate ... level of care. + * Processes adverse determination decision to Physician Advisor and distributes notification, as appropriate. + * Identifies problematic care… 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 patient… more
- Mount Sinai Health System (New York, NY)
- …to reduce readmission rate. + 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. + Collaborates with Physician and other clinicians to expedite diagnostic testing, treatment and… 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)
- …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
- 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
- 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
- Ellis Medicine (Schenectady, NY)
- …to determine appropriate reimbursement and appropriate status. * Escalates reviews timely to physician advisor timely for lack of medical necessity and/or status ... care facilities and providers. * Effectively communicates with the patient, family, physician and health care team to ensure understanding of appropriate management… more
- Arnot Health (Elmira, NY)
- …the Case Management practice. The Case Manager will work cooperatively with the Physician Advisor and Team. DUTIES AND RESPONSIBILITIES: ** 1. Determines medical ... necessity and appropriateness of admission and stay in accordance with Interqual. ** 2. Prepares Medicare/Non Medicare hospital notices of noncoverage (HINN) when patient's level of care is no longer covered according to the guidelines. ** 3. Identifies the… 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
- Evolent (Albany, NY)
- … Advisor will be primarily responsible for primary care physician IPA (Individual Practice Association and/or MSO (Management Services Organization) engagement ... more connected care journey. We are hiring for a Practice Performance Advisor to join our Provider Relations Team. **Collaboration Opportunities:** The Practice… more
- CUNY (New York, NY)
- Learning Community Facilitator - Medical Student Advisor (Clin. Prof.- Medical Series) **FACULTY VACANCY ANNOUNCEMENT** The CUNY School of Medicine (CSOM) at The ... CSOM also has a Master of Science degree in Physician Assistant Studies (PA). Our mission is to provide...serve in a non-tenure track position as Medical Student Advisor and Learning Community Facilitator. We will be filling… more
- CenterWell (Auburn, NY)
- …and help patients get back to the life they love. The Clinical Assessment Advisor directly completes and oversees development/ of the plan of treatment as approved ... by physician , performs ongoing evaluation of patient needs and coordinates...health aides to ensure optimal clinical outcomes. Works with physician and/or referral source to obtain all pertinent clinical… 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
- Northwell Health (New Hyde Park, NY)
- …and related services to clients of the Employee Assistance Program (EAP) and Physician 's Resource Network (PRN). Provides guidance to team members in order to ... identify and resolve personal/interpersonal concerns that may affect job performance of employees. Provides consultation and training to organization leadership to assist in management of employee issues that affect job performance. Job Responsibility +… 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