RN jobs in Albany, NY

Registered Nurse (RN) Jobs in Albany, NY

Utilization Review Nurse

$77,075 - $119,466 / year

Department/Unit: Care Management/Social Work Work Shift: Day (United States of America) Salary Range: $77,075.00 - $119,466.00 Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients. • Completes Utilization Management and Quality Screening for assigned patients. • Applies MCG criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Departmental standards. • While performing utilization review identifies areas for clinical documentation improvement and contacts appropriate department. • Identifies at-risk populations using approved screening tool and follows established reporting procedures. • Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas. • Refers cases and issues to Medical Director and Triad Team in compliance with Department procedures and follows up as indicated. • Communicates covered day reimbursement certification for assigned patients. • Discusses payor criteria and issues and a case-by-case basis with clinical staff and follows up to resolve problems with payors as needed. • Uses quality screens to identify potential issues and forwards information to the Quality Department. • Demonstrates proper use of MCG and documentation requirements through case review and inter-rater reliability studies. • Facilitates removal of delays and documents delays when they exist. Reports internal and external delays to the Triad Team. • Collaborates with the health care team and appropriate department in the management of care across the continuum of care by assuring communication with Triad Team and health care team. Minimum Qualifications: • Registered nurse with a New York State current license. • Associate's degree required. Bachelor's degree preferred. • Minimum of three years clinical experience in an assigned service. • Recent experience in case management, utilization management and/or discharge planning/home care in a high volume, acute care hospital preferred. PRI and • Case Management certification preferred. • Assertive and creative in problem solving, critical thinking skills, systems planning and patient care management. • Self-directed with the ability to adapt in a changing environment. • Basic knowledge of computer systems with skills applicable to utilization review process. • Excellent written and verbal communication skills. • Working knowledge of MCG criteria and ability to implement and utilize. • Understanding of Inpatient versus Outpatient surgery and ICD10-Coding (preferred) and Observation status qualifications. • Ability to work independently and demonstrate organizational and time management skills. • Strong analytic, data management and PC skills. • Working knowledge of Medicare regulatory requirements, Managed Care Plans Thank you for your interest in Albany Med Health System! Albany Med Health System is an equal opportunity employer. This role may require access to information considered sensitive to Albany Med Health System, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Outpatient

Full-time

1 month ago

Registered Nurse- RN-Internal Medicine

St. Peter's Health Partners Albany, NY

$36 - $47.52 / hour

Employment Type: Full time Shift: Day Shift Description: If you are looking for an RN II position in Albany, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. This position will be located on 326 S Pearl St Albany Position Highlights: Quality of Life: Where career opportunities and quality of life converge Advancement: Strong orientation program, generous tuition allowance and career development Work/Life: Monday - Friday: 4x10 hour day shift What you will do: The Registered Professional Nurse has the responsibility and accountability to utilize the nursing process to diagnose and treat human responses to actual or potential problems of individuals or groups. The Registered Professional Nurse works within and contributes to an environment where the St. Peter's Healthcare Services mission is actualized, patient outcomes are achieved, and professional practice is realized. Responsibilities: Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record. Review and update medication list to ensure accurate and complete list in electronic medical record (EMR) available for provider review and submission. Complete referrals and tracks patients' compliance. Review prescriptions electronically and send prescriptions to providers for review and submission. Obtains patient consent for procedures as directed by provider. Performs pre-visit planning and reviews quality metrics. Retrieves telephonic clinical information from patients who call into the office. Monitors task list and completes tasks assigned by provider in a timely manner based on urgency. Educates patients regarding medication, testing procedures and home care techniques. Ensure proper labeling, handling and documentation for patient specimens. Follow up with patient regarding test results based on advice given by provider. Maintains a clean and safe work environment including disinfecting patient care areas and equipment. In conjunction with other nursing colleagues, maintains the medical supply cabinet and drug cabinet. Uses the electronic medical record to communicate effectively. Performs quality assurance duties as assigned. Provides a clinical visit summary (Patient Plan) to patient as requested including educational materials. Participates in daily Patient Care huddles as appropriate. Works cooperatively with all colleagues to ensure quality patient care at all times. Performs other duties as assigned. What you will need: Associate or bachelor’s degree in nursing preferred (new grads accepted) HS Diploma/equivalent required Current unencumbered NYS RN license Basic Life Support certification 6 months previous RN experience Must be able to lift 20 lbs. RN Pay Range : $36.00 - $47.52 Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.