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Clinical Utilization Review Specialist
2 months ago
We are seeking a skilled Utilization Review Nurse to join our Care Management team at Albany Medical Center. As a key member of our team, you will be responsible for ensuring the efficient and effective use of healthcare resources while maintaining high-quality 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 patient needs and optimize resource use.
- Communicate with payors and other stakeholders to resolve issues and ensure timely reimbursement.
- Monitor and analyze data to identify trends and areas for improvement in utilization management.
- Develop and maintain relationships with healthcare providers and payors to ensure seamless care transitions.
- 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 an equal opportunity employer and offers a competitive salary and benefits package. If you are a motivated and detail-oriented individual with a passion for improving patient care, we encourage you to apply for this exciting opportunity.
