Utilization Review Nurse Specialist

18 hours ago


Coeymans, New York, United States Albany Medical Center Full time
Job Summary

We are seeking a skilled Utilization Review Nurse to join our team at Albany Medical Center. As a Utilization Review Nurse, you will play a critical role in ensuring the efficient and effective use of healthcare resources.

Key Responsibilities
  • Conduct thorough reviews of patient records to identify opportunities for cost savings and quality improvement.
  • Collaborate with healthcare teams to develop and implement plans to reduce length of stay and improve patient outcomes.
  • Communicate with payors and other stakeholders to resolve issues and ensure timely reimbursement.
  • Monitor and analyze data to identify trends and areas for improvement.
  • Develop and maintain relationships with healthcare providers and payors to ensure seamless coordination of care.
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.
What We Offer

Albany Medical Center is an equal opportunity employer and offers a competitive salary and benefits package.

This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes.

Workforce members are expected to ensure that access to information is based on a 'need to know' and is the minimum necessary to properly perform assigned duties.



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