Top 25 Utilization review nurse Jobs in Rochester Ny

RN, Utilization Management
University of Rochester —Rochester, NY
- $80,923 - $105,208 a year
- Full-time
- Nursing
- RN License
- Mid-level
Clinical Document Spec
University of Rochester —Rochester, NY
- $81,310 - $105,703 a year
- Full-time
- Nursing
- Medicine
- Surgery
RN Nurse Manager
Crest Manor Living and Rehabilitation Center —Rochester, NY
- $40.82 - $45.00 an hour
- Full-time
- Acute care
- Nursing
- Medication administration
- Health insurance
- 401(k)
Quick Apply
Remote RN Care Manager -NY Licensed Only
Xtreme Care —New York State
- $70,000 - $75,000 a year
- Full-time
- Remote
- Nursing
- Vital signs
- RN License
- Health insurance
- Dental insurance
Quick Apply
Bilingual Remote RN Care Manager -New York State
Xtreme Care —New York State
- $70,000 - $75,000 a year
- Full-time
- Remote
- Nursing
- Vital signs
- RN License
- Health insurance
- Dental insurance
Quick Apply
RN, Clinical Care, Prim Care
University of Rochester —Rochester, NY
- $76,689 - $103,521 a year
- Full-time
- CPR Certification
- Nursing
- RN License
7d
Nurse Navigator - Women's Health
Unity Hospital of Rochester —Rochester, NY
- $80,753 - $110,292 a year
- Full-time
- Nursing
- RN License
- Hospital
Quick Apply
RN MDS Coordinator
Blossom Healthcare Center —Rochester, NY
- $95,000 - $105,000 a year
- Full-time
- Mid-level
Quick Apply
1d
REGISTERED NURSE
CATHOLIC CHARITIES FAMILY AND COMMUNITY SERVICES —Rochester, NY
- $35 - $38 an hour
- Part-time
- Background check
- Spanish
- Nursing
- 403(b)
Quick Apply
RN Care Coordinator
Highland Hospital —Rochester, NY
- $77,220.15 - $93,600.00 a year
- Full-time
- Nursing
- RN License
- Hospital
3d
RN Care Manager
Highland Hospital —Rochester, NY
- $37 - $45 an hour
- Full-time
- CPR Certification
- Nursing
- Microsoft Excel
Registered Nurse (RN) Case Manager II, (Full-Time, Days), Homecare
Genesee Region Home Care Association Inc —Rochester, NY
- $77,983 - $103,906 a year
- Choose your own hours
- Nursing
- Computer literacy
- Mid-level
- Mileage reimbursement
- Tuition reimbursement
Quick Apply
Registered Nurse (RN) Case Manager, Palliative Home Care (Full-Time, Days)
Genesee Region Home Care Association Inc —Rochester, NY
- $77,983 - $103,906 a year
- Choose your own hours
- Nursing
- Management
- RN License
- Mileage reimbursement
- Tuition reimbursement
Quick Apply
20h

More jobs to discover

Find similar jobs that you might be interested in.

Clinical Document Spec
University of Rochester —Rochester, NY
Registered Nurse License, current in NYS upon hire required or NP – Nurse Practitioner license, current in NYS upon hire required or PA – Physician Assistant…
$81,310 - $105,703 a year
Clinical Research Spec II
University of Rochester —Rochester, NY
Assumes personal responsibility for keeping up with new developments in the field, related literature, and relevant clinical standards.
$24.91 - $34.87 an hour

Show more similar jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital - Columbus Vic Village(Grant) —Columbus, OH
Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per…
Quick Apply
RN Care Coordinator - Intake (PFK)
Nationwide Children's Hospital —Columbus, OH
Valid Ohio driver’s license and proof of auto insurance as required by hospital policy. Pediatric certification, Advanced-Continuity of Care Certification (A-…
1d

Show more jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in rochester ny

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization review nurse jobs near rochester ny

Registered Nurse Manager jobs in New York State

Mds Coordinator jobs in Rochester, NY

Nurse Navigator jobs in Rochester, NY

Registered Nurse jobs in Rochester, NY

Care Coordinator jobs in Rochester, NY

Registered Nurse Manager jobs in Rochester, NY

Clinical Documentation Specialist jobs in Rochester, NY

Clinical Nurse Coordinator jobs in Rochester, NY

Registered Nurse Case Manager jobs in Washington, DC

Registered Nurse Case Manager jobs in Kalispell, MT

Registered Nurse Case Manager jobs in Ocean County, NJ

Registered Nurse No Weekend No Holiday jobs in Indianapolis, IN

Registered Nurse jobs in Lawrence, MA

Nurse Rn jobs in Lakewood, WA

Registered Nurse Case Manager jobs in Germantown, MD

Registered Nurse jobs in Bay Saint Louis, MS

Registered Nurse Manager jobs in Duncansville, PA

Radiology Manager jobs in North Carolina

Registered Nurse Manager jobs in Providence, RI

Registered Nurse Manager jobs in Newton, IA

RN, Utilization Management

University of Rochester -
Rochester, NY

Apply Now

Job Details

Full-time
$80,923 - $105,208 a year

Qualifications

RN License
Associate's degree
Hospital experience

Full Job Description

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.

Job Location (Full Address):

601 Elmwood Ave, Rochester, New York, United States of America, 14642

Opening:

Worker Subtype:

Regular

Time Type:

Full time

Scheduled Weekly Hours:

Department:

500009 Utilization Management

Work Shift:

UR - Day (United States of America)

Range:

UR URCD 215

Compensation Range:

$80,923.00 - $105,208.00

The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations.

Responsibilities:

Works collaboratively with various departments across the entire health care system to review clinical documentation, utilizing evidence based criteria to support medical necessity and appropriate level of patient care for services provided. Reports outcome trends and patterns to UM leadership to help identify educational opportunities and performance improvement initiatives across the health care continuum. Adapts to process changes and assists with education efforts that support ongoing improvement.

ESSENTIAL FUNCTIONS

Determines level of care per regulatory requirements. Provides level of care notifications to patients and families as needed.
Works collaboratively with payers to ensure authorization for dates of service. Collaborates with HIM, providers, Financial Counseling and Patient Financial Services. Monitors all UM hold bills and unplanned readmission reports.
Conducts initial and concurrent reviews, utilizing evidence based criteria through Interqual. Supports discharge appeal process. Responsible for departmental denials and appeal activity.
Documents according to regulatory guidelines and UM RN workflow protocols. Conducts clinical documentation improvement efforts through query process.
Meets productivity expectations established by UM department.
Provides and supports ongoing educational needs for all UM customers.

MINIMUM EDUCATION & EXPERIENCE

Associate's degree in Nursing and 3 years of acute hospital experience required
Bachelor's degree in Nursing (BSN) preferred
Or equivalent combination of education and experience

KNOWLEDGE, SKILLS AND ABILITIES

Database experience including: Interqual, Sharepoint, eRecord, ePARC, Cobius preferred

LICENSES AND CERTIFICATIONS

RN - Registered Nurse - State Licensure and/or Compact State Licensure NYS Registered Nurse license upon hire required

The University of Rochester is committed to fostering, cultivating, and preserving an inclusive and welcoming culture to advance the University’s Mission to Learn, Discover, Heal, Create – and Make the World Ever Better. In support of our values and those of our society, the University is committed to not discriminating on the basis of age, color, disability, ethnicity, gender identity or expression, genetic information, marital status, military/veteran status, national origin, race, religion, creed, sex, sexual orientation, citizenship status, or any other characteristic protected by federal, state, or local law (Protected Characteristics). This commitment extends to non-discrimination in the administration of our policies, admissions, employment, access, and recruitment of candidates, for all persons consistent with our values and based on applicable law.

Apply Now

Refine Your Search

utilization review nurse jobs in rochester ny

RN, Utilization Management

Clinical Document Spec

RN Nurse Manager

Remote RN Care Manager -NY Licensed Only

Bilingual Remote RN Care Manager -New York State

RN, Clinical Care, Prim Care

Nurse Navigator - Women's Health

RN MDS Coordinator

REGISTERED NURSE

RN Care Coordinator

RN Care Manager

Registered Nurse (RN) Case Manager II, (Full-Time, Days), Homecare

Registered Nurse (RN) Case Manager, Palliative Home Care (Full-Time, Days)

More jobs to discover

Explore jobs in cities nearby

I want to receive the latest job alert for utilization review nurse in rochester ny

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected