What are the responsibilities and job description for the Utilization Review Nurse (RN) position at Niagara Falls Memorial Medical Center?
Niagara Falls Memorial is seeking a full time Utilization Review Nurse to join our team who is responsible for coordinating, integrating, and monitoring the use of medical and healthcare services for our patients.
Responsibilities:
· Performs medical necessity reviews prospectively, concurrently, and retrospectively for the appropriateness and quality of medical services, applying guidelines, and timely notification to payouts.
· Plans, implements, and documents utilization management activities which incorporate thorough understanding of clinical nursing knowledge, health plan benefits and efficient care delivery processes.
· Utilizes appropriate communication techniques with providers and other members of the multidisciplinary team to obtain medical information and assess need for continuation of medical services.
· Completes Patient Review Instrument (PRI) when requested.
Shift: Monday-Friday 8am-4pm
Requirements:
· Registered Nurse with current NYS License
· 3 years of clinical nursing experience
· Strong computer skills
· Excellent written and verbal communication skills
Benefits Include:
Generous Paid Time Off (PTO) Program
Extended Illness Bank
Competitive hourly rates
Group Life Insurance
Supplemental Short-Term Disability
Medical Insurance, Dental Insurance
Employee Assistance Program
403(b) Retirement & Savings Plan
Job-related Tuition Reimbursement Program
Who We Are:
Niagara Falls Memorial Medical Center is the only full-service hospital in Niagara County. The facility offers a 171-bed regional medical center with extensive inpatient and outpatient services, including a full-service Medical & Psychiatric Emergency Room, The Heart Center of Niagara featuring an on-site Cath Lab, Niagara Wellness Connection Center, The Wound Center of Niagara, OB/GYN Center and UBMD Orthopedics & Sports Medicine. We also offer a comprehensive range of surgical services.
The first hospital in Niagara to be designated a stroke center by the New York State Department of Health, we operate several satellite facilities, including the Summit Healthplex, Tuscarora Health Center, primary care offices in Niagara Falls, Wheatfield, and the Town of Niagara. Schoellkopf Health Center, a 120-bed skilled nursing facility that specializes in short-term rehabilitation and elder care. Like the medical center itself, Schoellkopf features 100-percent private room accommodation.
Niagara Falls Memorial's Child Advocacy Center of Niagara enjoys national accreditation. Our community health advocacy efforts coupled with extensive and productive community partnerships make us one of Western New York's most consistently innovative providers of community-based health outreach.
As one of the Greater Niagara region's largest employers, we pride ourselves on playing an active role as an economic engine and a catalyst for community growth.
Through growth and change, we remain faithful to our core mission: Improving the health of the Greater Niagara Region with a passion for excellence.
Job Types: Full-time, Part-time
Pay: $38.00 - $50.00 per year
Expected hours: 22.5 – 37.5 per week
Benefits:
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Day shift
- Monday to Friday
- Weekends as needed
Experience:
- Utilization review: 1 year (Preferred)
License/Certification:
- RN (Required)
Work Location: In person
Salary : $38 - $50
