Utilization Review Specialist I (RN)

Upstate Medical University; City of Syracuse (NY); Hybrid; USD 60,000 - 90,000; Full time

Job summary

Upstate Medical University in Syracuse, NY seeks a UR-CR Specialist I to ensure accurate recording and utilization of patient care services. Through chart review and screening criteria, you will verify appropriate level of care during the hospital stay and collaborate with medical teams and UR directors to determine care level.

You will act as a liaison for discharge appeals and social admissions, preparing regulatory notices for delivery to patients.

Qualifications

• RN licensed/eligible with a nursing degree and 3+ years acute care experience or ADN with 5 years experience.
• Broad knowledge of complex clinical concepts and level of care review.
• Strong written and verbal communication, and collaboration with leadership and regulatory bodies.
• Ability to manage assignments independently in a hybrid work setting.

Responsibilities

• Ensure patient care services are recorded and utilized per hospital standards and regulatory contracts.
• Perform thorough chart reviews and apply first-level screening criteria for level of care.
• Collaborate with medical team and UR directors to establish appropriate level of care.
• Act as liaison for discharge appeals and social admissions; prepare regulatory notices for patients.

Skills

Strong communication skills

Strong organizational skills

Technology proficiency

Education

Bachelor's Degree in Nursing

Associate's Degree in Nursing

Job description

Upstate Medical University in Syracuse, NY seeks a UR-CR Specialist I to ensure accurate recording and utilization of patient care services. Through chart review and screening criteria, you will verify appropriate level of care during the hospital stay and collaborate with medical teams and UR directors to determine care level.

You will act as a liaison for discharge appeals and social admissions, preparing regulatory notices for delivery to patients.