- 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
- WMCHealth (Valhalla, NY)
- Physician Advisor Company: WMC Advanced Physician Services PC City/State: Valhalla, NY Category: Allied Health Prof/Technical Department: Clinical Care Mgmt- ... (https://pm.healthcaresource.com/cs/wmc1/#/preApply/26206) Internal Applicant link Job Details: Job Summary: The Physician Advisor is responsible for developing positive… 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
- 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
- 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
- Nuvance Health (Danbury, CT)
- …prioritize improvement efforts, and negotiate with payers for fair reimbursement. * * Physician Advisor Collaboration:* Collaborate with the physician ... advisor (PA) group and leader to ensure processes and goals are aligned; including peer-to-peer results, observation rates, observation conversion rates, medical necessity outreach, and feedback to the utilization review team on denial outcomes. *… more
- Nuvance Health (Norwalk, CT)
- …and use of evidence based screening criteria. 3. Refers cases appropriately to Physician Advisor review. 4. Collaborates with SW Care Coordinators to assure ... Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology… 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
- CenterWell (Hauppauge, NY)
- …caring community and help us put health first** The RN 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
- New York State Civil Service (West Brentwood, NY)
- …HELP No Agency Addiction Services and Supports, Office of Title Hourly Clinical Physician 1 or 2 (CK Post ATC) Occupational Category Health Care, Human/Social ... on evenings, weekends, and during off hours.*Serve as health advisor to multi-disciplinary team; provide consultation/peer review to other physicians/clinicians;… more
- Nuvance Health (Danbury, CT)
- …Medical Center in New York - plus multiple primary and specialty care physician practices locations, including The Heart Center, a leading provider of cardiology ... care is offered through various affiliates, *Summary:* The Strategic Labor Relations Advisor (Eastern Region) plays a pivotal role in fostering positive and… more
- Catholic Health Services (Melville, NY)
- …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 ... The Professional Fee (ProFee) Clinical Documentation Specialist (CDS) will serve as an advisor and expert resource for providers to improve the accuracy of clinical… more
- Deloitte (Stamford, CT)
- …stakeholders, implement recommendations, and begin to build long-term trusted advisor relationships with client counterparts. Qualifications + Bachelor's degree + ... form, HCFA-1500, claim form and claim scrubber + Experience with hospital and physician financial and patient accounting systems, such as EPIC, Cerner, Soarian, SMS,… more