Utilization Review Nurse

2 days ago


Slingerlands NY United States Albany Medical Center Full time
Job Title: Utilization Review Nurse

Albany Medical Center is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for reviewing patient admissions and continued stays to ensure that they meet medical necessity and are in compliance with regulatory requirements.

Key Responsibilities:

  • Conduct thorough reviews of patient admissions and continued stays to determine medical necessity and compliance with regulatory requirements.
  • Communicate with healthcare providers and payers to resolve issues and ensure accurate and timely payment.
  • Collaborate with the healthcare team to develop and implement care plans that meet the needs of patients and ensure optimal outcomes.
  • Stay up-to-date with changing regulatory requirements and industry standards to ensure compliance and best practices.

Requirements:

  • Registered Nurse with a New York State current license.
  • 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.

What We Offer:

  • A competitive salary and benefits package.
  • A dynamic and supportive work environment.
  • Opportunities for professional growth and development.

Albany Medical Center is an equal opportunity employer and welcomes applications from diverse candidates. If you are a motivated and detail-oriented individual who is passionate about delivering high-quality patient care, we encourage you to apply for this exciting opportunity.



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