Physician Advisor: Utilization Review & Care Management

Mohawk Valley Health System; City of Utica (NY); Presencial; USD 180.000 - 230.000; Jornada completa

Descripción de la vacante

Mohawk Valley Health System (MVHS) is seeking a Physician Advisor to join our team in Utica, New York. The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level of care, patient billing status, and potential barriers to patient discharge.

The role conducts clinical review to ensure regulatory compliance, hospital objectives, and quality patient care while promoting efficient utilization of resources and providing guidance to improve clinical and

Responsabilidades

• Educate and support physician documentation for appropriateness of admission and continued stay, severity, and morbidity/mortality.
• Review patient status when admission criteria is non-sufficient for admission.
• Monitor observation and the application of the 2nd Midnight across payor types (CMS regulation).
• Perform concurrent review and escalation of cases not meeting criteria.
• Provide guidance and advisory services
• Deliver support associated with palliative care, end-of-life-care and hospice.
• Track and trend outcome KPIs for financial and compliance best practice results. Provide individual education based on trends and regulatory changes.

Descripción del empleo

Mohawk Valley Health System (MVHS) is seeking a Physician Advisor to join our team in Utica, New York. The Physician Advisor collaborates with Care Managers and Attending Physicians to align on the level of care, patient billing status, and potential barriers to patient discharge.

The role conducts clinical review to ensure regulatory compliance, hospital objectives, and quality patient care while promoting efficient utilization of resources and providing guidance to improve clinical and