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Utilization Review Nurse Specialist
2 months ago
Albany Medical Center is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate care while minimizing unnecessary costs.
Key Responsibilities:- Conduct thorough reviews of patient records to identify areas for improvement in care and resource utilization.
- Apply MCG criteria to monitor the appropriateness of admissions and continued stays, and document findings based on Departmental standards.
- Identify at-risk populations using approved screening tools and follow established reporting procedures.
- Collaborate with the healthcare team to develop and implement plans to improve patient outcomes and reduce costs.
- Communicate with payors and other stakeholders to resolve issues and ensure seamless care transitions.
- 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 and is committed to providing a work environment that is free from discrimination and harassment. We are proud to be a part of the Albany Medical Center team and look forward to hearing from you.
