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

Glens Falls Hospital•Glens Falls, NY

5d•Onsite

About The Position

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.

Requirements

Current Registered Nurse (RN) in New York State
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

Nice To Haves

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.

Responsibilities

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.
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.”