- 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 (Melville, 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
- 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
- Mount Sinai Health System (New York, NY)
- …and responsive to the diverse backgrounds and experience of others. * Liaison with Physician Advisor . 2. Case Management: * Assessment of the patient's clinical, ... reduce readmission rate. * Appropriately identifies and refers cases to the physician advisor to support timely progression of patients along the continuum of… 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)
- …Managers, as warranted, to review medically complex and long stay cases; refer to physician advisor as indicated. 3. Collaborates with Social Work Supervisors to ... Managers to review medically complex and long stay cases: refer to physician advisor as required. 12. Collaborates with Social Work Supervisors to resolve… 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
- Mount Sinai Health System (New York, NY)
- …to reduce readmission rate. 8. 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. 3. Collaborates with Physician and other clinicians to expedite diagnostic testing, treatment and… 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
- 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
- CUNY (Queens, NY)
- Senior Academic Advisor (ACE Program) **POSITION DETAILS** York College, founded in 1966, is a center of academic excellence in the heart of Jamaica, Queens. One of ... Aviation Management, Clinical Trials Management, Pharmaceutical Science and Business, Physician Assistant, Social Work and Nursing Education. Located in Queens,… more
- Evolent (Albany, NY)
- …more connected care journey. We are hiring for a Part-Time Practice Performance Advisor to join our Evolent Care Partners Performance Team. The Part-Time Practice ... Performance Advisor will serve as the local expert and resource...will travel throughout designated territory to build relationships with physician practices to support physician engagement, clinical… more
- CUNY (New York, NY)
- Academic Advisor **POSITION DETAILS** The CUNY School of Medicine (CUNY SoM) located in the heart of Harlem, New York, is the only medical school in the City ... 2016. The CUNY SoM offers an accelerated BS/MD degree (7-year program) and a Physician Assistant Master's Degree (27 months program). True to its legacy of access,… more
- Evolent (Albany, NY)
- …your mark on health care. **Collaboration Opportunities:** The Practice Performance Improvement Advisor will serve as the local expert and resource for Evolent Care ... region for value-based care initiatives. The Practice Performance Improvement Advisor will travel throughout designated territory to build relationships with… 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