Utilization review nurse Jobs in New York, NY

Employment Type : Full time Shift :

Day Shift

Description :

The RN Utilization Management Nurse Coordinator is responsible for both concurrent and retrospective inpatient and outpatient services, in accordance with the utilization requirements and 3rd party payor contracts. The UM department is responsible for LOS and Level of Care to provide effective and efficient health care services that best serve the needs of the patient. Nurses in this position work within and contribute to an environment where patient focused outcomes are achieved, and high-quality professional practice is realized.

Position Purpose : Registered Nurse Coordinator is a dynamic leadership role that contributes to the operational management of the unit to promote and support an environment of excellent patient care. An individual in this role ensures compliance with all healthcare standards and requirements established by various licensing, regulatory, and accreditation bodies. A Coordinator maintains a working knowledge of policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior. A Coordinator provides department / unit-based leadership while engaging staff and promoting evidenced based practice that supports and leads unit and / or organizational changes. A RN Coordinator helps to identify problems, offers solutions, and participates in their resolution. A candidate for this role should be comfortable providing patient care, managing staff, making decisions independently, and assuming managerial duties as necessary.

What you will do :

• Develops, coordinates, and implements staffing plans to ensure adequate care coverage and adjusts department productivity to meet targets.
• Participates in all aspects of utilization management. Assist with strategies, plans and workflow development in the UMCC department, gather and renew denial metrics, review and evaluate LOS O / E metrics for trends and opportunities, manage EPIC work QS to completion, assist with UM scheduling and assignments, mentoring / supervising UM staff, assist with education of UM staff regarding new processes and updates, serve on UM committees, assists with UM meeting in gathering and evaluating pertinent data for presentation.
• Manages urgent / emergent situations by reallocating personnel and resources as needed.
• Participate in hiring, evaluating, initiating corrective action and terminating employees as necessary and educates team members in clinical competencies.

Minimum Qualifications :

Position Highlights and Benefits :

Ministry / Facility Information.

Located in the heart of central New York, St. Joseph's is one of America's 50 Best Hospitals for Cardiac Surgery and one of America's 100 Best for Spine Surgery and Coronary Intervention according to Healthgrades. It is ranked by Consumer Reports among the top 15 heart surgery centers in the country, a designated Stroke Center, a U.S. News Best Regional Hospital and Best Maternity Hospital. With a comprehensive range of primary-care practices, mental health services, women's and infants' care, and oncology services, St. Joesph's Health network offers a wide range of innovative, community-based health and wellness programs. Our high-quality specialty and mental health services aim to coordinate the continuum of care, as a compassionate healing presence to improve all aspects of health. Joining our team means becoming part of a nationally recognized, elite group of healthcare professionals who are passionate about patient care and supporting one another.

The above statements are intended to describe the general nature & level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.

Pay Range : $41.85 - $59.00

Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

Our Commitment to Diversity and Inclusion

Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.