Utilization Management Specialist (RN): Salary, 40hrs/week - DAYS

Department/Unit:
Care Management/Social Work


Work Shift:
Day (United States of America)


Salary Range:
$84,783.00 - $131,414.00


Under direction of the Manager of Utilization Management, the Utilization Management Specialist is responsible for the coordination, processing and tracking of all potential utilization concerns from the third party payors for Albany Medical Center; and to do other related work as required. This individual will act as a liaison with all payors and review agents, providing required acuity information regarding patients and issuing notice of non-coverage as appropriate. This position is also responsible for the processing of adverse determinations received from third party payors, coordinating with Patient Financials Services, Admitting/Access Operations, attending physicians, Medical Director and AMC Case Managers and R1 Physician advisory services.


Requirements:

+ Graduate of a profes...