Registered Nurse – Quality & Utilization Review Coordinator - SUNYWNYRN

Registered Nurse – Quality & Utilization Review Coordinator

Qualifications:

• RN license with experience in quality assurance or utilization review.
• Minimum of 3 years in a hospital or managed care setting.
• Knowledge of regulatory standards, including CMS and Joint Commission guidelines.
• Strong written and verbal communication skills.
• Proficiency in data analysis and performance improvement strategies.

Duties:

• Assess healthcare services for efficiency, effectiveness, and compliance.
• Conduct retrospective and concurrent medical necessity reviews.
• Develop and implement quality improvement initiatives.
• Analyze trends in utilization and make recommendations for policy adjustments.
• Work closely with case managers and providers to optimize patient outcomes.
• Ensure adherence to accreditation and regulatory requirements.

Pay:

• Medium weekly pay range: $2,100 - $2,600