Location: Rochester,NY, USA
As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.
Job Location (Full Address):
220 Hutchison Rd, Rochester, New York, United States of America, 14620
Opening:
Worker Subtype:
Regular
Time Type:
Full time
Scheduled Weekly Hours:
40
Department:
500009 Utilization Management
Work Shift:
Range:
UR URCB 213
Compensation Range:
$69,326.00 - $90,124.00
The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.
Responsibilities:
The Utilization Management (UM) RN position spans the entire health care system working collaboratively with Health Information Management, Financial Counseling, Patient Financial Services, Providers, Social Work, Patients, and various insurance companies. The UM RN is responsible for the review of clinical documentation utilizing evidence based criteria to support medical necessity, and appropriate level of patient care for services provided. The UM RN is also responsible for reviewing outcome trends and patterns to identify educational opportunities and performance improvement processes across the health care continuum. In addition, the UM RN is responsible for auditing the quality of clinical documentation and providing education based on findings. The role requires strong communications skills and critical thinking skills.
Schedule 8 AM-4:30 PM; WKNDS AS NEEDED Responsibilities General Description: The Utilization Management Nurse role is a unique and exciting opportunity that blends the knowledge of nursing and the business aspects of the healthcare system. The position spans the entire healthcare system working collaboratively with Health Information Management, Financial Counselors, Patient Financial Services, Physicians, Social Work, patients, and various insurance companies. The UM RN is responsible for the review of clinical documentation utilizing evidence-based criteria to support medical necessity and appropriate level of patient care for services provided. The UM RN is also responsible for reviewing outcome trends and patterns to identify educational opportunities and performance improvement processes across the healthcare continuum. The role requires strong communication skills and critical thinking skills. Primarily Monday through Friday with occasional off-shift and weekend commitments depending on the needs of the department. The majority of work is remote with some on-site requirements as needed. Qualifications: RN with Utilization Review experience preferred; 3-5 years of recent acute hospital experience required. The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University?s mission to Learn, Discover, Heal, Create ? and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.
EOE Minorities / Females / Protected Veterans / Disabled:
The University of Rochester is committed to fostering, cultivating, and preserving a culture of equity, diversity, and inclusion to advance the University's mission to Learn, Discover, Heal, Create - and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion/creed, sex, sexual orientation, citizenship status, or any other status protected by law. This commitment extends to the administration of our policies, admissions, employment, access, and recruitment of candidates from underrepresented populations, veterans, and persons with disabilities consistent with these values and government contractor Affirmative Action obligations.