Leader, Concurrent Review
6 days ago
Rochester
At MVP Health Care, we're on a mission to create a healthier future for everyone - which requires innovative thinking and continuous improvement. To achieve this, we're looking for a Leader, Concurrent Review to join #TeamMVP. If you have a passion for patient advocacy, efficiency and accuracy, team leadership and development this is the opportunity for you. What's in it for you: • Growth opportunities to uplevel your career, • A people-centric culture embracing and celebrating diverse perspectives, backgrounds, and experiences within our team, • Competitive compensation and comprehensive benefits focused on well-being, • An opportunity to shape the future of health care by joining a team recognized as a Best Place to Work For in the NY Capital District, one of the Best Companies to Work For in New York, and an Inclusive Workplace. Qualifications you'll bring: • Current and unrestricted NY, VT RN license., • Associate or bachelor's degree in nursing (BSN preferred)., • Minimum 4 years of clinical nursing experience., • At least 2 years in utilization management sub-acute care review., • 2+ years of supervisory experience, • Strong understanding of concurrent review, sub-acute care, rehabilitation, and skilled nursing services., • Knowledge of discharge planning processes and transitional care coordination., • Ability to lead and motivate clinical teams., • Proficiency in applying clinical criteria and interpreting medical records, • Experience with EMR systems and UM platforms., • Familiarity with CMS regulations and appeals processes., • Strong communication, conflict resolution, and organizational skills., • Curiosity to foster innovation and pave the way for growth, • Humility to play as a team, • Commitment to being the difference for our customers in every interaction Your key responsibilities: • Supervise and support RN staff performing UM reviews., • Ensure timely, accurate, and compliant review of medical necessity and level of care., • Monitor and guide discharge planning efforts to ensure safe and appropriate transitions of care., • Provide coaching, feedback, and performance evaluations for team members., • Serve as a clinical resource and escalation point for complex cases., • Collaborate with interdisciplinary teams, providers, and facilities to resolve care coordination issues., • Ensure documentation meets regulatory and organizational standards., • Participate in audits, quality improvement initiatives, and training programs., • Other duties as assigned by leadership., • Contribute to our humble pursuit of excellence by performing various responsibilities that may arise, reflecting our collective goal of enhancing healthcare delivery and being the difference for the customer. Where you'll be: Hybrid Pay Transparency MVP Health Care is committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role. We do not request current or historical salary information from candidates. MVP's Inclusion Statement At MVP Health Care, we believe creating healthier communities begins with nurturing a healthy workplace. As an organization, we strive to create space for individuals from diverse backgrounds and all walks of life to have a voice and thrive. Our shared curiosity and connectedness make us stronger, and our unique perspectives are catalysts for creativity and collaboration. MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, color, creed, national origin, citizenship, ethnicity, ancestry, sex, gender identity, gender expression, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications. To support a safe, drug-free workplace, pre-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our Talent team at .