Utilization Review Coordinator

Kaleida Health; Buffalo (NY); On-site; USD 63,000 - 81,000; Full time

Job summary

Kaleida Health is seeking an Utilization Review Coordinator in Buffalo, NY. This role coordinates utilization management and case reviews to align patient needs with resources, ensuring quality and cost-effective outcomes.

A strong nursing and case management background is ideal for this position. The role offers a full-time day shift at Buffalo General Medical Center, with emphasis on coordinating across preadmission, ambulatory, and inpatient settings.

Qualifications

• BS in Nursing is required.
• Current NYS Registered Nurse license required.
• CCM certification preferred.

Responsibilities

• Coordinate utilization management and case review efficiently.
• Align patient needs with available resources.
• Achieve optimal outcomes across preadmission and ambulatory settings.
• Conduct case reviews in clinic, physician office, and inpatient settings.

Skills

Nursing

Case management

Utilization review

Clinical coordination

Education

BS - Bachelor of Science degree in Nursing

Current NYS Registration as a Professional Nurse

Certified Case Manager (CCM) preferred

Job description

About This Role

The Utilization Review Coordinator is responsible for coordinating utilization management and case review to align patient needs with resources, ensuring quality, clinical, and cost outcomes. This role is ideal for those with a strong background in nursing and 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.
• Achieve optimal outcomes for patients in various settings including preadmission and ambulatory surgery.
• Conduct case reviews in 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 aligning patient needs with quality resources to achieve optimal health outcomes.