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Clinical Utilization Specialist

2 months ago


Cohoes, New York, United States Albany Medical Center Full time
Care Management Specialist

Albany Medical Center seeks a skilled Care Management Specialist to join our team. As a key member of our Care Management department, you will play a critical role in ensuring the highest quality patient care and outcomes.

Responsibilities:
  • Conduct thorough utilization reviews to identify opportunities for improvement in patient care and resource utilization.
  • Collaborate with healthcare teams to develop and implement effective care plans that meet the unique needs of each patient.
  • Monitor and analyze patient data to identify trends and areas for improvement.
  • Communicate with payors and other stakeholders to resolve issues and ensure seamless care transitions.
  • Participate in quality improvement initiatives to enhance patient outcomes and reduce costs.
Requirements:
  • Registered nurse with a New York State current license.
  • Bachelor's degree preferred.
  • Minimum of three years clinical experience in an assigned service.
  • Recent experience in case management, utilization management, and/or discharge planning/home care in a high-volume, acute care hospital preferred.
  • Case Management certification preferred.

Albany Medical Center is an equal opportunity employer. This role may require access to sensitive information, and workforce members are expected to ensure that access is based on a 'need to know' and is the minimum necessary to properly perform assigned duties.