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Utilization Review Coordinator

2 months ago

Buffalo, New York, United States StateJobsNY Full time
Job Summary

We are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a Utilization Review Coordinator, you will play a critical role in analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.

Key Responsibilities
  • Review clinical records for completeness and accuracy to ensure compliance with established criteria.
  • Collect and analyze data related to the utilization review process and prepare reports on findings, patterns, and trends.
  • Review medical records of new admissions, placement decisions, length of stays, and discharge plans against established criteria to determine if necessary and effective.
Requirements
  • Bachelor's degree in a human services field and 3 years of utilization review experience in a healthcare facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards.
  • Possession of a license and registration to practice nursing and 2 years of post-licensure nursing experience, one of which must have included utilization review and/or discharge planning.
  • Candidates within State Service can be considered for a competitive class appointment if they are reachable on the current Utilization Review Coordinator eligible list.
  • Candidates within State Service can be considered for a competitive class appointment if they have 1 year of permanent competitive or 55-b/55-c service in a title eligible for transfer under Section 70.1 of the Civil Service Law.
Benefits
  • NYS medical, dental, and vision insurance.
  • Access to tuition assistance programs.
  • Excellent opportunities for advancement and professional growth.
  • Paid time off - 13 paid vacation days in the first year, 5 paid personal days, 13 paid holidays, and paid sick leave.
  • NYS Retirement programs.