Utilization Review Nurse Specialist
3 days ago
We are seeking a skilled Utilization Review Nurse to join our team at Albany Medical Center. As a key member of our Care Management department, you will play a critical role in ensuring the efficient and effective use of healthcare resources.
Key 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 needs of patients and reduce unnecessary costs.
- Utilize MCG criteria to monitor appropriateness of admissions and continued stays, and document findings based on departmental standards.
- Identify areas for clinical documentation improvement and work with clinical staff to implement changes.
- Monitor length of stay (LOS) and ancillary resource use, taking actions to achieve continuous improvement in both areas.
- Communicate with payors and resolve issues on a case-by-case basis.
- Use quality screens to identify potential issues and forward information to the Quality Department.
- 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 a leading healthcare provider in the Capital Region, dedicated to delivering high-quality patient care and advancing medical research and education.
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Utilization Review Nurse Specialist
3 days ago
Coeymans, New York, United States Albany Medical Center Full timeJob SummaryWe 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 ResponsibilitiesConduct thorough reviews of patient cases to determine medical necessity and appropriateness of care.Apply...
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Utilization Review Nurse Specialist
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Coeymans, New York, United States Albany Medical Center Full timeJob SummaryWe 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 ResponsibilitiesConduct thorough reviews of patient records to identify opportunities for cost savings and quality...
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Utilization Review Nurse Specialist
3 days ago
Coeymans, New York, United States Albany Medical Center Full timeJob SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Albany Medical Center. As a key member of our Care Management department, you will play a critical role in ensuring the efficient and effective use of healthcare resources.Key ResponsibilitiesConduct thorough utilization reviews to identify opportunities for improvement in...
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Clinical Utilization Specialist
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Coeymans, New York, United States Albany Medical Center Full time{"title": "Clinical Utilization Specialist", "content": "Job SummaryAlbany Medical Center seeks a skilled Clinical Utilization Specialist to join our Care Management team. In this role, you will be responsible for ensuring the efficient and effective use of healthcare resources while maintaining high-quality patient care.Key ResponsibilitiesConduct thorough...
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Utilization Review Nurse
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