Registered Nurse (RN) Utilization Review - Care Management (Acute Care)

Salary Range
The expected base rate for this Glens Falls, New York, United States-based position is $35.50 to $60.24 per hour. (Exact rate is determined on a case-by-case basis commensurate with exp­­erience level, as well as education and certifications pertaining to each position which may be above the listed job requirements).

Why Choose Glens Falls Hospital:

Glens Falls Hospital is seeking dedicated and compassionate Registered Nurses to join our team. Our Care Management Department ensures the timely and accurate assessment of a patient’s transitional care plan from the acute care setting to the home or other healthcare setting, thus, meeting the health and psychosocial needs of the patient. As a Registered Nurse you will facilitate safe transitional care practices to reduce readmissions and to ensure safe transition from the acute care setting to the post-acute care setting.

Team Impact

As a Utilization Review RN, you will work in collaboration with the physician and interdisciplinary team to support the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payers. The role integrates and coordinates utilization management and denial prevention by focusing on identifying and removing unnecessary and redundant care, and promoting clinical best practice. Ensuring all patients receive “the right care, the right cost, right time, and in the right setting.”

Glens Falls Hospital Nursing

Glens Falls Hospital is proud to be a Magnet designated organization, joining only 10% of all hospitals in the United States to currently hold this distinction. Magnet Recognition is the gold standard for nursing excellence.

When you join Magnet Designated nursing excellence team, you will experience shared governance, engaged leadership, and skilled team members all in a family-like atmosphere.

Qualifications

Education/Licensure/Accredited Programs

• Bachelors of Nursing (BSN) is preferred at hire, and is required within 5 years of hire. Exceptions may be made for Associate’s degree RN with relevant experience and obtains certification in case management (CCM or ACM) within 1 year.

• Two years of acute care, utilization management, or payer experience preferred.

• Current Registered Nurse (RN) in New York State

Skills/Abilities

• Ability to function autonomously maintaining a high level of clinical and professional accountability

• Demonstrates skill in creative problem solving, facilitation, collaboration, coordination and critical thinking

• Embraces change and continuously identifies opportunities for improvement by demonstrating a commitment to creativity and innovation.

• Committed to promoting excellence in Customer Service; functions as a team player

• Computer literacy and data analysis skills are required

• Maintains professional image by demonstrating strong verbal and written communication skills

• Demonstrates ability in self-starting, self-directing and clear decision making behaviors