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Skills: Utilization Review, Discharge Planning, Denials Management, Interqual, Case Management
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$62/hr–$71/hr
Full-time
bachelor degree, postgraduate degree
Posted 58d ago
~38 hrs/week
Responsibilities
The coordinator manages concurrent and retrospective payment denials, analyzes trends, and educates staff on documentation. They facilitate patient care coordination and work with interdisciplinary teams to ensure cost-effective, high-quality care.
Requirements
Requires a Bachelor's degree, New York State RN licensure, and at least 5 years of clinical experience with supervisory experience in utilization review or discharge planning. Proficiency in Microsoft Office and specific software like SAVVY, Invision, and RAX is required.
Full job description
It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
Day Shift - 7.5 Hours (United States of America)
The Clinical Resource Manager Coordinator will act as a resource to the Case Managers and other disciplines relative to concurrent and retrospective denials of payments. She/he will maintain payer database and updates reports as necessary (mail/log). The Coordinator will analyze denials and appeals for patterns and trends. Provides reports and researches trends in denials. Educates regarding documentation to support the patients admission (from the ED) and hospitalization stay. She/he will serve as on-site appeals coordinator and responds to retrospective denials. Discharge planning, clinical reviews and unit coverage as staffing warrants. She/he will be responsible for timely facilitation and coordination of patient care for a specific patient population or area of assignment. The job responsibilities include working effectively with the interdisciplinary team so as to plan and implement an individualized program of care that promotes high quality, efficient and cost effective care. Must assess the patient needs utilizing established standards/interqual, and other approved clinical guidelines. Ongoing communication with third party representatives and facilitate care that meets established patient care needs while optimizing care and reimbursement. Participate in committees and special projects.
-Current registration in New York State as an RN, Diploma and Licensure required.
-PRI and Screen certificate required.
-Must have at least 5 years of clinical experience as a Registered Nurse and supervisory experience with utilization review or discharge planning.
-Interqual knowledge/experience preferred.
-Knowledge of Microsoft Word and Excel required.
-SAVVY, Invision, RAX experience required.
Days w/ eo wknds & hols; 8a-4p
Salary Range: $62.339/hr - $71.223/hr (Commensurate with Experience)
Employment Non-Discrimination: Richmond University Medical Center is committed to equality of opportunity in all aspects of employment and provides full and equal employment opportunities to all employees and potential employees without regard to race, color, national origin, religion, gender identity, sex, sexual orientation, pregnancy, childbirth and related medical conditions and needs including lactation accommodations, physical or mental disability, age, immigration or citizenship status, veteran or active military status, genetic information, or any other legally protected status.
If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
Related keywords
Registered NurseRNUtilization ReviewDischarge PlanningInterqualDenials ManagementCase ManagementClinical Resource ManagerSAVVYInvisionRAXPatient Care CoordinationHealthcare AdministrationNew York State LicensurePRI CertificateScreen Certificate
A not-for-profit healthcare provider serving the ethnically diverse community of Staten Island and its neighbors.
Industry
Hospitals and Health Care
Company size
1,001-5,000 employees
Headquarters
Staten Island, New York
LinkedIn followers
8,180
Total funding
$54M
Richmond University Medical Center (RUMC), an affiliate of The Mount Sinai Hospital and the Icahn School of Medicine, is a 470+ bed healthcare facility and teaching institution serving borough residents as a leader in the areas of acute, medical and surgical care, including emergency care, surgery, minimally invasive laparoscopic and robotic surgery, gastroenterology, cardiology, pediatrics, podiatry, endocrinology, urology, oncology, orthopedics, neonatal intensive care and maternal health. The medical center earned The Joint Commission’s Gold Seal of Approval® for quality and patient safety.
RUMC is a Level 1 Trauma Center and a designated Stroke Center, receiving top national recognition from the American Heart Association/American Stroke Association. The state-of-the-art Cardiac Catheterization Lab has PCI capabilities for elective and emergent procedures in angioplasty. RUMC maintains a Wound Care/Hyperbaric Center and a Sleep Disorder Center on-site at its main campus. The hospital also offers behavioral health services, encompassing both inpatient and outpatient services for children, adolescents and adults, including emergent inpatient and mobile outreach units. RUMC is the only borough facility that offers inpatient psychiatric services for adolescents.
With over 2,500 employees, RUMC is one of the largest employers on Staten Island. Its main campus is located at 355 Bard Avenue, Staten Island, New York 10310.
Offices: 355 Bard Avenue, Staten Island, New York 10310, US · 355 Bard Ave, Staten Island, NY 10310, US
SurgeryGastroenterologyPediatricsPediatric GastroenterologyEndocrinologyUrologyOncologyOrthopedicsMental HealthLabor and Delivery
How many Administrative jobs are open in New York, NY right now?
There are currently 9,157 open administrative positions in New York, NY listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Administrative roles in New York, NY?
Companies currently hiring include New York City Housing Authority (NYCHA), Mount Sinai Health System, Northwell Health, NYU London, Compass Group, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Administrative jobs in New York, NY?
Yes — 2121 of the 9157 open administrative positions offer remote or hybrid work (275 remote, 1846 hybrid).
How do I apply for Administrative jobs in New York, NY?
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