Utilization Review Nurse Specialist
2 days ago
SUNY Downstate Medical Center is a leading healthcare provider in the region, committed to delivering exceptional patient care and advancing medical knowledge. Our team of dedicated professionals shares a passion for excellence and a commitment to making a difference in the lives of our patients and communities.
Job Summary
We are seeking a highly skilled Utilization Review Nurse to join our team. The successful candidate will be responsible for conducting thorough reviews of patient cases to ensure medical necessity and appropriateness of care, while also working closely with healthcare providers to coordinate high-quality patient care. This is a full-time position working nights, with a competitive salary of $**$83,400 - $113,000 per year**, depending on experience and qualifications.
Responsibilities
- Conduct comprehensive reviews of patient cases to determine medical necessity and appropriateness of care
- Collaborate with healthcare providers to coordinate high-quality patient care
- Communicate effectively with patients, families, and healthcare teams to ensure seamless care coordination
- Analyze data and trends to identify opportunities for quality improvement
- Stay up-to-date with changing regulations and best practices in utilization review
Requirements
- Bachelor's degree in Nursing (BSN) or related field
- Current licensure as a Registered Nurse (RN) in New York State
- Prior experience in utilization review or case management
- Strong analytical and communication skills
- Ability to work independently and as part of a team
Benefits
- Competitive salary range: $83,400 - $113,000 per year
- Comprehensive benefits package, including health insurance, retirement plan, and paid time off
- Opportunities for professional growth and development
- A dynamic and supportive work environment
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