Registered Nurse (RN) Utilization Review - Care Management (Acute Care)
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Glens Falls Hospital
NY
Summary
The Utilization Review RN coordinates transitional care plans to ensure safe patient movement from acute to post-acute settings. They collaborate with interdisciplinary teams to optimize clinical outcomes and manage the cost of care while preventing insurance denials.
Job Description
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
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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.
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Two years of acute care, utilization management, or payer experience preferred.
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Current Registered Nurse (RN) in New York State
Skills/Abilities
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Ability to function autonomously maintaining a high level of clinical and professional accountability
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Demonstrates skill in creative problem solving, facilitation, collaboration, coordination and critical thinking
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Embraces change and continuously identifies opportunities for improvement by demonstrating a commitment to creativity and innovation.
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Committed to promoting excellence in Customer Service; functions as a team player
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Computer literacy and data analysis skills are required
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Maintains professional image by demonstrating strong verbal and written communication skills
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Demonstrates ability in self-starting, self-directing and clear decision making behaviors
Mission
Our mission is to improve the health of people in our region by providing access to exceptional, affordable, and patient-centered care every day and in every setting.
Communities We Serve
Located in the foothills of the beautiful Adirondack mountains, Glens Falls is conveniently located a short drive away from the capital region and Lake George. Work at the top of your profession and jumpstart your next career here at Glens Falls Hospital!
All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law.
Benefits
Glens Falls Hospital is committed to providing our people with valuable and competitive benefits offerings, as it is a core part of providing a strong overall employee experience. A summary of these offerings, which are available to active, full-time and part-time employees who work at least 30 hours per week, can be found on the career page here.
Glens Falls Hospital (GFH) maintains a service area that spans 6,000 square miles across 5 diverse counties. Founded in 1897, GFH today operates an advanced health care delivery system featuring 20 regional facilities. A vast array of specialized medical and surgical services are provided in addition to coronary care, behavioral health care, rehabilitation and wellness and others. The main hospital campus is home to the C.R. Wood Cancer Center, the Joyce Stock Snuggery birthing center, the Breast Center and a chronic wound healing center. GFH is a not-for-profit organization and the largest employer in New York’s Adirondack region, with over 2,300 employees and a medical staff of over 550 providers. Glens Falls Hospital is an affiliate of the Albany Med Health System, which also includes Albany Medical Center, Columbia Memorial Health and Saratoga Hospital. For more information visit www.GlensFallsHospital.org.
Founded
1897
Company size
1,001-5,000 employees
Industry
Hospitals and Health Care
Org type
Nonprofit
Headquarters
Glens Falls, NY
Glens Falls Hospital (GFH) maintains a service area that spans 6,000 square miles across 5 diverse counties. Founded in 1897, GFH today operates an advanced health care delivery system featuring 20 regional facilities. A vast array of specialized medical and surgical services are provided in addition to coronary care, behavioral health care, rehabilitation and wellness and others. The main hospital campus is home to the C.R. Wood Cancer Center, the Joyce Stock Snuggery birthing center, the Breast Center and a chronic wound healing center. GFH is a not-for-profit organization and the largest employer in New York’s Adirondack region, with over 2,300 employees and a medical staff of over 550 providers. Glens Falls Hospital is an affiliate of the Albany Med Health System, which also includes Albany Medical Center, Columbia Memorial Health and Saratoga Hospital. For more information visit www.GlensFallsHospital.org.
Founded
1897
Company size
1,001-5,000 employees
Industry
Hospitals and Health Care
Org type
Nonprofit
Headquarters
Glens Falls, NY