Clinical Utilization Review Nurse – Case Management

Kaleida Health; Buffalo (NY); On-site; USD 97,000 - 124,000; Full time

Job summary

Kaleida Health's Utilization Review Coordinator position at Buffalo General Medical Center in Buffalo, NY, requires coordination of utilization management and case reviews to align patient needs with resources. The role covers preadmission, ambulatory surgery, clinic, physician offices and inpatient settings.

BSN and NYS RN registration are required, with CCM preferred. A mix of nursing experience in acute care, case management and utilization review is expected.

Qualifications

• Bachelor of Science degree in Nursing and NYS RN registration.
• CCM preferred; 3+ years in acute care nursing with 2 years in case management/utilization review.
• Proficiency with Microsoft Office Suite and Outlook; familiarity with health care software.
• Knowledge of Interqual Criteria Set and related software preferred.

Responsibilities

• Coordinate utilization management/case review to align patient needs with resources and outcomes.
• Perform case reviews in preadmission, ambulatory surgery, clinic, physician office and inpatient settings.
• Work full-time onsite with 8a-4p schedule.
• Onsite utilization review coordination at Buffalo General Medical Center.

Skills

Acute care nursing

Case management

Education

Bachelor of Science in Nursing

NYS Registration as a Professional Nurse

Certified Case Manager (CCM) preferred

3 years experience in acute care nursing

Tools

Microsoft Office Suite

Interqual Criteria Set/Software

Job description

Kaleida Health's Utilization Review Coordinator position at Buffalo General Medical Center in Buffalo, NY, requires coordination of utilization management and case reviews to align patient needs with resources. The role covers preadmission, ambulatory surgery, clinic, physician offices and inpatient settings.

BSN and NYS RN registration are required, with CCM preferred. A mix of nursing experience in acute care, case management and utilization review is expected.