Department/Unit: Care Management/Social Work
Work Shift: Day
Salary: $65,062.40 - $107,348.80
Job Summary:
- Conduct utilization management and quality screening for assigned patients
- Apply MCG criteria to monitor appropriateness of admissions and continued stays
- Identify areas for clinical documentation improvement and initiate appropriate action
- Monitor length of stay and resource use, taking actions to achieve improvement
- Communicate with medical director and triad team as needed
- Identify at-risk populations using approved screening tool
- Referral of cases and issues to medical director and triad team
- Discuss payor criteria and issues with clinical staff
- Collaborate with the healthcare team in care management
Minimum Qualifications:
- Registered nurse with a New York State license
- Bachelor's degree preferred
- Minimum of three years clinical experience
- Recent experience in case management, utilization management, or discharge planning
- Assertive and creative problem-solving skills
- Ability to work independently and adapt in a changing environment
- Knowledge of computer systems and MCG criteria
- Strong analytic and data management skills
- Understanding of Medicare regulatory requirements and managed care plans
Thank you for your interest in Albany Medical Center!
Albany Medical is an equal opportunity employer.