Clinical Utilization Specialist

2 weeks ago


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

We are seeking a skilled Clinical Utilization Specialist 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 delivery of patient care.

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 unique needs of each patient.
  • Monitor and analyze data to identify trends and areas for improvement in patient outcomes and resource utilization.
  • Communicate with payors and other stakeholders to resolve issues and ensure seamless care transitions.
  • Participate in quality improvement initiatives to enhance the overall quality of patient 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.
  • Case Management certification preferred.
What We Offer

Albany Medical Center is an equal opportunity employer. We offer a competitive salary and benefits package, as well as opportunities for professional growth and development.



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