Job Description

Join Our Team at Albany Medical Center!

Are you ready to make a difference in patient care? We are looking for a dedicated professional to join our Care Management/Social Work team in Gallupville, NY. This is your chance to play a vital role in Utilization Management, Quality Screening, and Delay Management for our patients.

About the Role

As a key member of our team, you will:

• Conduct Utilization Management and Quality Screening for assigned patients, ensuring the highest standards of care.
• Apply MCG criteria to monitor the appropriateness of admissions and continued stays, documenting findings in line with departmental standards.
• Identify areas for clinical documentation improvement and collaborate with the appropriate departments.
• Monitor Length of Stay (LOS) and resource use, taking proactive steps for continuous improvement.
• Communicate effectively with clinical staff regarding payor criteria and resolve any issues that arise.
• Facilitate the removal of delays in patient care and document any existing delays for reporting.
• Collaborate with the healthcare team to manage care across the continuum, ensuring seamless communication.

What We’re Looking For

To thrive in this role, you should have:

• Current New York State RN License and a Bachelor’s degree (preferred).
• At least three years of clinical experience in a relevant service area.
• Experience in case management, utilization management, or discharge planning in a high-volume acute care hospital (preferred).
• Strong problem-solving and critical thinking skills with a creative approach to patient care management.
• Excellent communication skills , both written and verbal.
• Basic computer skills relevant to the utilization review process.
• Knowledge of MCG criteria and familiarity with Medicare regulatory requirements and Managed Care Plans.

Working Conditions

This position operates during the day shift, providing a structured work environment that allows you to focus on delivering exceptional patient care.

Why Join Us?

At Albany Medical Center, we value our employees and offer:

• Competitive Salary: Ranging from $71,612.39 to $110,999.20.
• Growth Opportunities: We encourage continuous learning and professional development.
• Supportive Work Environment: Join a team that values collaboration and communication.
• Commitment to Diversity: We are an equal opportunity employer, welcoming individuals from all backgrounds.

Thank you for considering a career with Albany Medical Center! We look forward to your application and the possibility of you joining our dedicated team.

Note: This role may require access to sensitive information, including HIPAA Protected Health Information. All workforce members are expected to adhere to strict confidentiality and data protection standards.

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