Utilization Review and Quality Assurance Coordinator
2 days ago
About the Job
SUNY Downstate Health Sciences University is seeking an experienced Utilization Review Nurse / TH Utilization Review/Quality Assurance Senior Coordinator to join our Department of Care Management. This full-time position will play a critical role in ensuring the quality and efficiency of patient care.
Job Summary
- Utilize clinical expertise to review patient cases and determine medical necessity and appropriateness of care.
- Collaborate with the medical team to develop and implement discharge plans and optimize patient outcomes.
- Conduct regular quality assurance reviews to identify areas for improvement and develop strategies to address them.
- Develop and maintain strong relationships with payors, hospitals, and other healthcare organizations to ensure seamless care coordination.
Requirements
- Active New York State Registered Nurse License.
- PRI Certification.
Preferred Qualifications
- Graduate degree in the healthcare field.
- Case Management Certification.
Salary Range: $90,000 - $120,000 per year, based on experience and qualifications.
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