Utilization Review Coordinator

IntelliResume; Buffalo (NY); On-site; USD 63,370,000 - 169,059,000; Full time

Job summary

Kaleida Health in Buffalo, NY is seeking an Utilization Review Coordinator to oversee utilization management and case review, ensuring patient needs align with available resources to support quality and cost outcomes. This role is a Full-Time, Day shift position at Buffalo General Medical Center.

You will coordinate reviews across preadmission, ambulatory surgery, clinic, physician office, and inpatient settings.

Qualifications

• BS in Nursing and NYS Registered Professional Nurse (RN) are required.
• Certified Case Manager (CCM) preferred.
• 3 years of acute care nursing experience; 2 years in case management or utilization review.

Responsibilities

• Coordinate utilization management and case review efficiently.
• Align current and prospective patients' needs with resources.
• Work to achieve optimal outcomes for patients.
• Conduct case reviews in preadmission, ambulatory surgery, clinic, physician office, and inpatient settings.

Skills

Utilization management

Case management

Nursing care

Education

BS - Bachelor of Science in Nursing

NYS Registered Professional Nurse (RN)

Job description

About This Role

The Utilization Review Coordinator is responsible for coordinating utilization management and case review, ensuring alignment of patient needs with resources to achieve quality, clinical, and cost outcomes. This role is ideal for those with a strong background in nursing and experience in case management.

Highlights

• Pay: $46 - $59/hour
• Location: Buffalo, NY
• Facility: Buffalo General Medical Center
• Schedule: Full-Time, Day shift

What You'll Do

• Coordinate utilization management and case review efficiently and effectively.
• Align current and prospective patients' needs with resources.
• Work to achieve optimal outcomes for patients.
• Conduct case reviews in preadmission, ambulatory surgery, clinic, physician office, and inpatient settings.

Requirements

Education:

• BS - Bachelor of Science degree in Nursing required. Current NYS Registration as a Professional Nurse.
• Certified Case Manager (CCM) preferred.

Experience:

• 3 years of experience in acute care nursing.
• 2 years of experience in any combination of case management, home care, and utilization review.

Licenses & Certifications:

• Current NYS Registration as a Professional Nurse.
• Certified Case Manager (CCM) preferred.

About Kaleida Health

Kaleida Health is a leading healthcare provider committed to delivering exceptional patient care. They focus on improving the health of the communities they serve through innovative and compassionate care.