Clinical Utilization Physician Advisor - NYC Trauma Center

PHYSICIAN AFFILIATE GROUP OF NEW YORK; New York (NY); On-site; USD 241,000 - 246,000; Full time

Benefits offered by this job

CME Reimbursement

401(k) Company Contribution

Paid Time Off

Job summary

PHYSICIAN AFFILIATE GROUP OF NEW YORK (PAGNY) seeks a full-time Physician Advisor for Clinical utilization at NYC Health + Hospitals/Kings County. You will identify denial trends, perform root cause analysis, and educate clinicians on documentation and ICD-10 alignment.

Collaborate with ED and case managers to improve level-of-care documentation at entry. NY license required; board-eligible/certified in Internal Medicine.

Qualifications

• Identify denial trends and perform root cause analysis.
• Educate physicians on documentation best practices and ICD-10 coding.
• Collaborate with ED and case managers to improve utilization management workflows.

Responsibilities

• Review medical records for utilization management and regulatory alignment.
• Escalate clinical questions to licensed clinicians as appropriate.
• Participate in Utilization Review Committee and policy development.

Skills

Utilization management

Documentation improvement

ICD-10 alignment

Interdepartmental collaboration

Education

MD/DO Internal Medicine

New York State license

Board eligible/certified in IM

Job description

PHYSICIAN AFFILIATE GROUP OF NEW YORK (PAGNY) seeks a full-time Physician Advisor for Clinical utilization at NYC Health + Hospitals/Kings County. You will identify denial trends, perform root cause analysis, and educate clinicians on documentation and ICD-10 alignment.

Collaborate with ED and case managers to improve level-of-care documentation at entry. NY license required; board-eligible/certified in Internal Medicine.