Utilization Review RN- Onsite

Job Description

The University of Vermont Health Network is seeking a dedicated Utilization Review RN to join our team at the Emergency Department of Champlain Valley Physicians Hospital (CVPH) in Plattsburgh, NY. As a key member of the team, you will be responsible for monitoring, analyzing data, and evaluating resource utilization to ensure optimal care in a cost-effective manner.

Responsibilities

• Monitor and analyze data to evaluate resource utilization and quality of care.
• Support performance improvement and quality programs.
• Coordinate internal and external resources for appropriate resource management.
• Identify opportunities for process improvement and risk management.

Qualifications

• Current New York State Registered Nurse license required.
• CCM Preferred. Utilization review and discharge planning experience preferred.
• Three years of broad clinical nursing experience is required.
• Quality assurance/risk management experience preferred.
• Experience with InterQual preferred. Knowledge of MCG a plus.
• Knowledge of Medicare, Department of Health, and The Joint Commission regulations preferred.