Utilization review nurse jobs in Rochester, New YorkCreate job alerts

Job Title: Nurse Manager, Ambulatory Services Department: Pulmonary, Sleep Lab, Infectious Disease and eHealth Location: Riedman Campus (100 Kings Highway South Irondequoit, NY 14617) with frequent travel to Linden Oaks, Unity Hospital, Newark, Batavia, Rochester General Hospital, and St. Mary's Hours Per Week: 40 Schedule: Monday-Friday 8am-4pm (occasional evening or early am to meet with the sleep lab supervisor and team) SUMMARY: Develops and sustains an environment that supports excellence in clinical practice and the care of patients within an assigned service line across all RRH affiliates. Plans and directs clinical practice for a systematized Specialty Medicine and Surgery Service Line. Works collaboratively with operational leadership and physician leadership to develop budgets based on volumes and scope of practice. Develops nursing guidelines and standards for the delivery of care. Focuses on customer service as it relates to patients, visitors, family members, staff and physicians including working collaboratively with other disciplines to ensure an efficient, team approach to the delivery of patient care. Responsible for service line quality and performance improvement initiatives, medication management, risk management, infection prevention and regulatory preparedness. Collaborates with Directors of Nursing and Director of Quality to provide quality review activities. Guides assigned areas in utilization of recognized improvement tools, data analysis and outcome measures. RESPONSIBILITIES: * Develops and sustains an environment that supports excellence in clinical practice and promotes quality patient care with a focus on safety. * Develops programs and strategies to monitor the quality of patient care and patient outcomes. * Promotes collaboration with physician and operational colleagues in establishing system service line patient care goals and daily operations. * Ensures that the philosophy, standards and policies of the organization are translated into action in the ambulatory practices. Responsible for coaching and performance management of clinical support staff when not meeting expectations. * Develops, justifies and implements, in collaboration with the Director of Nursing and operational leadership, the long-term staffing pattern, personnel complement needs and recruitment plan for clinical support staff within the service line. * Works collaboratively with operational and physician leadership to allocate resources to achieve clinical care and financial goals by preparing, monitoring, and maintaining approved salary and non-salary budgets. * Selects and develops staff to meet patient care goals. * Oversight of clinical support orientation and competencies across system service line * Monitors and evaluates operations for compliance with licensure, accreditation and regulatory standards. * Supports and facilitates staff professional development and participation in research programs. * Demonstrates leadership and influences others in both the internal and external environments to promote optimal care to individual patients and optimal health care services to the public. * Pursues a continuing program of self-development in order to maintain, strengthen and broaden own concepts, philosophy and abilities. * Accountability for Clinical Regulatory Compliance * Performs clinical practice assessments on all newly acquired and newly opened practices to ensure compliance with regulations, codes, accreditations, scope of practice, RRH policy and federal, state, and local health laws. * Perform other duties as assigned. REQUIRED QUALIFICATIONS: * BSN required. * 3 years nursing experience. * NYS RN License. * Basic Life Support (BLS) Certification. PREFERRED QUALIFICATIONS: * Previous nursing leadership within the ambulatory setting strongly preferred EDUCATION: BS: Nursing LICENSES / CERTIFICATIONS: PHYSICAL REQUIREMENTS: M - Medium Work - Exerting 20 to 50 pounds of force occasionally, and/or 10 to 25 pounds of force frequently, and/or greater than negligible up to 10 pounds of force constantly to move objects; Requires frequent walking, standing or squatting. For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements. Any physical requirements reported by a prospective employee and/or employee’s physician or delegate will be considered for accommodations. PAY RANGE: $85,000.00 - $135,000.00 CITY: Rochester POSTAL CODE: 14617 The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts. Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.

Job Description In this Supervisor role you will assist IPRO’s Senior Director and the New York State Department of Health (NYSDOH), Office of Aging and Long-Term Care, Long Term care, with oversight of surveillance and investigation activities related to nursing homes (long term care). These activities are mandated to evaluate facility performance and monitor the quality of care and services provided. Duties include but are not limited to ensuring the quantity and quality of IPRO staff work output with acceptable outcomes; working with IPRO’s designated staff to ensure correct invoicing are submitted for staff; coordinating and assisting in providing preceptor surveillance training to IPRO surveyors; participating as a member of an interdisciplinary survey team and producing written documentation and draft Statements of Deficiencies (SOD); attend meetings and other duties assigned. The position will be located at the NYS DOH lower Manhattan OR Central Islip office. Non-travel days are based at the designated office or telecommuting, if approved. QUALIFICATIONS: • Demonstrate strong interpersonal skills with the ability to facilitate positive customer satisfaction in situations that are adverse or in controversy., • Ability to successfully work independently with minimal supervision, as well as in a team environment., • Excellent written and verbal skills with the ability to communicate professionally with co-workers, supervisors, providers, medical and administrative personnel, and residents/patients., • Ability to translate collected information into a clear, concise, legal, and defensible document., • Excellent investigative and analytical skills., • Strong computer skills with working knowledge of Microsoft office products, and the ability to learn new programs., • If approved to work remotely, must have secure internet that meets the speed required to perform all work duties, must have a workspace that provides privacy for all work-related calls, and must be able to secure all work-related items when not in use., • Must have a valid driver’s license & the ability to travel to on-site facilities review assignments. EDUCATION & EXPERIENCE: • NYS Licensed, Registered Nurse, required., • A minimum of two (2) years of experience in performing utilization review, claims adjudication, medical review, fraud investigation, surveillance, or monitoring activities, OR, three (3) years of clinical or administrative experience, OR A bachelor’s degree in nursing and two (2) years of clinical or administrative experience and two (2) years of supervisory experience., • Surveyor Minimum Qualifications Test (SMQT), required. The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The salary range for this position is $109,750.00- $115,996.50. Actual salary range and /or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget. The salary range and/or hourly rate listed does not include other forms of compensation or benefits. IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, protected veteran status or military status or any other category protected under applicable law.

Job DescriptionDescription: We are Hiring! Job Posting: REGISTERED NURSE Location: 146 Hobart St Department: Nursing Employment Type: Limited Part-Time Schedule: Weekend Saturday and Sunday Salary: $35 - $38/hr General Description Under general supervision, provides comprehensive health services and supervision for LPN and/or Medical Liaison staff if applicable. Works collaboratively with other providers to facilitate client wellness. Maintains all applicable confidentiality and ethical standards of relevant governing bodies. Effectively supports ongoing and collaborative communication amongst all program staff and is responsible for ensuring a trauma informed care environment. Essential Duties and Responsibilities • Provides a comprehensive health assessment of clients., • Identifies immediate and long-term health care needs., • Makes appropriate referrals and recommendations based on findings of the health assessments., • Assists clients in identifying local resources., • Communicates and collaborates with appropriate Agency staff, Primary Health care provider, community justice agencies, and related community organizations to assure coordination of client care and services., • Completes required paperwork related to the health assessment process., • Provide oversight and supervision of any assigned LPN and/or Medical Liaison Staff:, • Required supervision of tasks performed by LPN and/or Medical Liaison staff may include medication monitoring or administration, monitoring of vital signs, reporting of signs or symptoms of potential health concerns, basic emergency medical treatment or interventions., • Direct, coach, collaborate with and delegate tasks appropriately., • Build and sustains cooperative working relationships among program staff., • Assist in the initiation and implementation of staff development and training programs to maximize professional practice., • Accesses employees’ skills and program needs and appropriately assign staff to meet program needs., • Participates in selection, hiring, and orientation of Staff., • Coordinates employee schedules to ensure day-to-day coverage of the Programs., • Reviews and approves timesheets., • Evaluates program effectiveness and recommends alternatives as required., • Assists Prescribers, • Provide health monitoring for clients, • Administers Injectable medications as prescribed, • Responsible for case load records, • Completes required case record documentation in accordance with regulations and other record keeping as necessary for program accountability, • Participates in monthly Utilization Review, quality assurance and program evaluation activities as directed., • Coordinates discharge planning for clients, • Provides education to clients on health and wellness issues., • Participates in staff meetings and clinical supervision as directed, • Actively pursues development of professional competencies related to job role performance through reading, supervision, in-service training and attendance at conferences and workshops. Qualifications Education: Minimum of an Associate’s Degree in Nursing required. Bachelor’s or Master’s Degree in Nursing preferred. Credentials: Valid and clean NYS Driver’s License. Valid Registered Professional Nurse (RN) License required Experience: At least two years of experience related to nursing services to individuals with mental health, chemical dependency, substance use disorder, or intellectual/developmental disabilities-related services strongly preferred. Bi-lingual in Spanish also preferred. Physical Demands/Work Environment: The physical demands/work environment described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, talk, hear, stand, walk, use hands to type and/or perform light lifting. Specific vision abilities required by this job include close vision, distance vision and ability to adjust focus. The noise level in the work environment is usually quiet. Compliance: Adheres to all applicable federal and state laws and regulations including, but not limited to, those governing confidentiality, privacy, program, billing, and documentation standards. All duties must be performed in accordance with CCFCS’s corporate compliance & ethics program. Additional Requirements: • Ability to prioritize assignments, plan, and complete work projects with minimal direction,, • An ability to work efficiently and effectively and meet deadlines,, • An ability to work under pressure,, • Excellent verbal/written skills,, • Ability to maintain confidentiality,, • Ability to demonstrate behaviors and attitudes which support agency mission, philosophy, and policies., • Willingness and ability to foster agency and program wide cooperation and teamwork through use of positive/constructive communication techniques,, • Competitive salary and 403b retirement plan, • Generous time off package and work-life balance, • Comprehensive benefits package, • Supportive and collaborative environment, • Opportunities for growth and development ***Catholic Charities is committed to leveraging the talent of a diverse workforce to create great opportunities for our agency and our people. EOE/AA Disability/Vet Requirements:

Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding.

Job Title: Salesforce Project Manager.Location: NY/NJ (Hybrid – 3 days/week).Seeking a Senior Project Manager to lead Salesforce B2B delivery projects, managing end-to-end execution, stakeholders, and cross-functional teams.Manage multiple Salesforce projects (scope, timeline, budget).Drive projec

Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve supply cost goals following all guidelines established in the organization formularies.

Works directly with the physicians and physician assistants.Prepares patients to see the physicians or physician assistants by assessing the reason for the visit and documenting past and present medical history.Facilitates diagnostic tests and paperwork as needed and assists the physician with clini

Assistant Director of Nursing (ADON) – Rochester, NY.K–$120K | 🕒 Full-Time | SNF/LTC.Are you a hands-on RN leader ready to take your career to the next level?.Assistant Director of Nursing (ADON).Skilled Nursing and Long-Term Care facility in.This is your chance to lead a passionate nursing t

Our mission is to help nurses thrive and advance their careers by providing exceptional job opportunities, day-one benefits, and 24/7 support. The Travel Registered Nurse (RN) provides high-quality patient care across a variety of healthcare settings and specialties. Registered Nurses may work acros

Prepares, reviews, and administers contracts, project documents, technical specifications, and project status documents. Develops metrics and monitors/leads reviews on adherence to project plans, including schedule, budget, compliance, quality, technical and operational needs.

Working at the Naval Nuclear Laboratory we foster pride in belonging to an organization whose culture is made up of these core values: Trust, Empowerment, and Collaboration.Our company promotes a positive culture while ensuring the safety and reliability of our nation's naval nuclear reactors, and t

Position: Project Manager - Industrial Automation.Applying for this role is straight forward Scroll down and click on Apply to be considered for this position.Location: Rochester, NY or Painted Post, NY.Compensation: 120,000k – 150,000k base + bonus.Travel: ~30% (primarily regional day trips with

First Learning is one of North America's largest providers of high-quality early education for children.Founded in 1991 with the opening of Care-a-lot's first childcare center in Greece, the organization quickly built a strong reputation that fueled growth across the Rochester community.Between 2023

The Dental Specialists Rochester Pediatrics is seeking a compassionate, professional Patient Care Coordinator to join our team-oriented practice.As a Patient Care Coordinator you will play an important role in working with our doctor teams.You will check in patients, schedule patient appointments us

Run Client Schedule Report daily, to ensure visits are verified for billing as well as review of visits missed, reassigned, declined and office reassigned status.

Registered Nurse (RN) Floor Nurse. As a Registered Nurse (RN), Provide advice & support to the Residents and their families. Current State Registered Nurse RN License.

Lead project review meetings with project teams and customers.

Monitor overall care & review individual Resident cases. Charge Nurse experience preferred. Registered Nurse (RN) Supervisor - Weekends.

We're hiring an ERP Project Manager (Oracle Fusion) to lead cloud ERP implementations across finance and procurement.This is a great and rewarding opportunity to work on high-impact transformation programs with a collaborative, fast-moving team.If you have hands-on experience delivering Oracle Fusio

Facilitate weekly project reviews to keep Engineering, Procurement, and Production aligned.

Facilities Services/Management.Join our Facilities Management team in a fast-paced, customer-focused role delivering construction management, architectural design, and code compliance support across a diverse portfolio of projects.This position manages multiple initiatives—from renovations and cap

Run internal project review meetings.

You will manage technical teams, work closely with internal and external customers, and ensure programs deliver on technical, schedule, and business goals.Lead cross-functional technical teams and resolve complex program challenges.Define and execute program plans, including.Maintain close engagemen

Beyond TalentEdge has a direct hire opportunity for an experienced Broadband Project Manager and Consultant.A FULL JOB DESCRIPTION CAN BE PROVIDED TO QUALIFIED/INTERESTED CANDIDATES.In this position you will oversee the planning, execution, and closing of fiber or wireless network infrastructure pro

Description: HVAC Assistant Project Manager Salary: $50,000–$70,000 Location: Staten Island 10302 Type: Full-time TemPositions is pleased to partner with a well-established HVAC and mechanical contracting firm serving commercial and residential clients across NYC.We are seeking an HVAC Assistant P

Responsibilities: Assigned to specific capital equipment project(s) Work direction provided by designated Engineering resources Integrated into existing engineering workforce Assigned multiple projects and/or project tasks based on business needs Reports directly to Engineering Project Manager Execu

Our client is looking to add a Registered Nurse to their team. Offering a comprehensive benefits package, travel nurses have immediate access to medical coverage and ReviveHealth virtual care. Our experienced Healthcare and Medical Staffing experts are committed to providing safe and quality patient

The Good Life MedStaff is seeking a travel nurse RN Home Health Case Management for a travel nursing job in Webster, New York.

The Gifted Healthcare Experience.Gifted Healthcare is an award-winning agency that offers contracts and shifts at premier facilities across the United States.Gifted Healthcare believes in the power one person has to make a difference in a patient's care, inspiring Gifted's mission to help clinicians

As a Registered Nurse (RN), you’re the engine and the heart of patient care at Rochester Regional Health. Because of this, our nurses develop a strong set of skills and knowledge that they can use to grow their career throughout the acute care environment. Completes at least one clinical research

THE POSITION: Labor and Delivery Nurses help bring people into the world every day. As a Labor and Delivery Nurse, you'll prepare women, and their families, for the stages of giving birth and help patients with breastfeeding after the baby is born.