Utilization Review Manager - Home Care jobs in New York, NY

• Understands and adheres to the WPH Performance Standards, Policies and Behaviors
• Completes a comprehensive initial assessment.
• Performs all activities for multidisciplinary care coordination at the intra-hospital level of care and inter-hospital level of care.
• Performs all transitional planning activities including but not limited to:  Patient/caregiver education  Arrangement of all aftercare  Commercial payer involvement  High utilizer patient root cause
• Communicates and collaborates all relevant patient information to appropriate health team members.
• Ensures department goals of LOS reduction, readmission prevention, denial reduction, and satisfaction improvement are realized.
• Documents per department requirements.
• Participates in Performance Improvement activities as needed.
• Performs all UR activities per department policy:  Commercial payer reviews  Disposition determination,  Retro/self-audit  MC variance  Admission clinical review.
• The RN Care Manager collaborates with all Health Care professionals to evaluate the needs and the safe discharge of all geriatric patients including but not limited to inpatients, emergency department and surgical outpatients.
• Performs all other related duties as assigned

Job Type: Contract

Pay: $68.00 - $70.00 per hour

Schedule:

• 12 hour shift
• Day shift

Education:

• Bachelor's (Required)

Experience:

• Case Manager/Utilization review: 2 years (Required)

License/Certification:

• BLS (Required)
• NY State license (Required)

Work Location: In person