Utilization Management - Registered Nurse

Crouse Hospital

$80K — $85K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Current New York State Registered Nurse (RN) license required.
  • Graduate from an accredited nursing degree program required.
  • Bachelor of Science in Nursing preferred, with requirement for recent grads to obtain within 8 years.
  • Certification in a specialty area preferred.
  • 3-5 years of acute hospital experience necessary.
  • Experience in Case Management or Utilization Management preferred.

Responsibilities

  • Collaborate with a multidisciplinary healthcare team to allocate resources efficiently while ensuring quality care.
  • Demonstrate proficiency in standard Utilization Review processes.
  • Conduct concurrent and continued stay reviews for Utilization Management and ensure data is tracked accurately.
  • Advance patients through the continuum of care based on admission status.
  • Establish and maintain processes for determining appropriate admission statuses according to regulations and payer requirements.

Benefits

  • Medical, Dental, Vision, FSA, and 401K plans available.
  • Company-paid life insurance offered.
  • Opportunities for tuition assistance and workforce development.
  • Employee Assistance Program provided.
  • Discounts available on inpatient/outpatient services, cafeteria, pharmacy, and selected retailers.
  • YMCA Subsidy program access.
  • Clinical Nursing Pathway Program available for career development.
Full Job Description
Care Coordination Services team is hiring a Utilization Management Registered Nurse (RN) to track and manage data and client care as it relates to the utilization of services.

Pay Range: $80,000.00 - $85,000.00 / year

Utilization Management RNs are eligible for up to a $10,000 Sign-On Bonus!

Available Schedule(s):
  • Full Time: 8:00am-4:30pm with occasional weekends (typically requires 6 weekends a year).

Utilization Management Registered Nurse (RN) Position Responsibilities:
  • Works collaboratively with the multidisciplinary healthcare team to ensure the appropriate allocation of hospital resources while maintaining the quality of care.
  • Demonstrates proficiency with standard Utilization Review processes.
  • Responsible for concurrent and continued stay Utilization Management related reviews and functions and for ensuring that appropriate data is tracked, evaluated and reported.
  • Progresses patients through the continuum of care based on their appropriate admission status.
  • Maintains effective and efficient processes for determining appropriate admission status based on the regulatory and reimbursement requirements of various commercial and government payers.

Utilization Management Registered Nurse (RN) Position Requirements:
  • Must have a current New York State Registered Nurse (RN) license.
  • Graduate from an accredited nursing degree program required.
  • Bachelor of Science degree in Nursing preferred.
    • For RNs licensed in or after 2017, completion of a Bachelor's of Nursing Degree will be required within 8 years of the date the license was obtained.
  • Certification in a specialty area preferred.
  • Three (3) - Five (5) years acute hospital experience.
  • Case Management or Utilization Management experience preferred.

Benefits Overview:
  • Medical, Dental, Vision, FSA, and 401K.
  • Company paid life insurance.
  • Tuition Assistance and Workforce Development Opportunities.
  • Crouse Health Employee Assistance Program.
  • Employee discounts on any Inpatient or Outpatient service, hospital cafeteria and pharmacy, and certain retailers.
  • YMCA Subsidy program.
  • Clinical Nursing Pathway Program for Registered Nurses designed to foster career growth and progression. Learn more here: https://www.crouse.org/nursingpathway/

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