Care Coordination RN: Discharge & Utilization Specialist

925 St. Lawrence Health; United States; Remote; USD 70,000 - 95,000; Full time

Job summary

Rochester Regional Health is seeking a Care Facilitator in the Case Management department at Canton-Potsdam Hospital. The role includes planning with the health care team, coordinating patient care across the continuum and ensuring appropriate care delivery aligned with payer requirements.

Travel to other sites is expected; weekend shifts occur periodically. The position requires a NYS Registered Nurse license and an accredited nursing degree; 3 years of acute hospital care experience may be

Qualifications

• Nurse license in NYS.
• 3 years acute hospital care experience required (post 10/28/2024).
• Bachelor’s degree preferred.

Responsibilities

• Conduct clinical reviews using InterQual criteria to assign level of care.
• Document level of care and medical necessity in Care Management Database.
• Monitor resource utilization and conduct continued stay reviews.
• Refer cases to Review Physician Advisor for validation of level of care.
• Serve as a resource on payor requirements and communicate with payors.

Skills

Nursing license

Care coordination

Discharge planning

Utilization management

Education

Diploma in Nursing

Associate's Degree in Nursing

Tools

None

Job description

Rochester Regional Health is seeking a Care Facilitator in the Case Management department at Canton-Potsdam Hospital. The role includes planning with the health care team, coordinating patient care across the continuum and ensuring appropriate care delivery aligned with payer requirements.

Travel to other sites is expected; weekend shifts occur periodically. The position requires a NYS Registered Nurse license and an accredited nursing degree; 3 years of acute hospital care experience may be