Nursing Jobs in Penfield, NY
$114,000 - $130,000 / year
Main Function: Under the general supervision of Obstetrician/Gynecologist(s), provides clinical medicine services and applicable administrative services to Thompson Hospital OB/GYN patients in our beautiful Canandaigua Medical Group building in the heart of Canandaigua, NY. Provides consistent, high quality care consistent with accepted national and/or community standards. Collaborates with office staff in development and performance of efficient office practices. Assures regulatory compliance. Provides patient management and role modeling that unifies department goals with health system goals. Acts in the best interest of the patient. Assists the health system in meeting strategic goals. Ability to develop and maintain collaborative relationships with hospital leaders, office staff and providers. S/he must have the ability to assess data reflective of the patient’s status, interpret the appropriate information needed to identify each patient’s requirements relative to her age-specific needs and provide the necessary care. Knowledge of recognized best patient care practices. Maintains current knowledge of and ability to institute programs necessary to comply with evolving regulatory requirements. Lives the CARES values at all times (Commitment Action Respect Excellence & Service) Generates legible, meaningful, comprehensive and timely patient care records sufficient for all patient care, regulatory, billing and other uses of the medical record. Shift: Monday-Friday day shift hours, no weekends, no on call! Qualifications: NYS certification/registration as a Family or Adult Nurse Practitioner required. AANP Board Certification. DEA license required. Able to gain appropriate FFTH privileges required. Knowledge of ICD-10 coding preferred. Education: Graduation from an AMA approved school as a Nurse Practitioner. Meets continuing education requirements of the applicable discipline board. Experience: Previous experience as a Women’s Health Nurse Practitioner preferred. Previous experience in primary care medicine is beneficial. Pay Range: $114,000-130,000/year Starting Pay : Based on Experience Thompson Health is an EOE encouraging individuals with disabilities and veterans to apply $86,528 - $118,976 / year
Job Title: Utilization Review Educator - Registered Nurse Department: Physician Advisor Program -Utilization Review Location: Rochester General Hospital Hours Per Week: 40 Full Time Schedule: Days - M-F SUMMARY: Comprehensively plans with the health care team to ensure patient needs are met and care delivery is coordinated across the continuum. Identifies and works to eliminate/minimize system variation and service delivery barriers that prevent achievement of optimal patient outcomes in the expected time frame and with most efficient utilization of resources. Carries out activities related to utilization review. Performs as an integral part of the interdisciplinary team promoting interdisciplinary collaboration and champions service excellence. Facilitates assignment of level of care, considers payer requirements and responds accordingly to avoid adverse financial consequence to patient and hospital. Provide superior customer service by modeling the Brand Promise and Core Values. RESPONSIBILITIES : Conducts clinical reviews utilizing nationally recognized standards of care guidelines to evaluate hospital admissions and assigns patient to the appropriate level of care; identifies clinical resources required to achieve optimal patient outcomes and appropriate reimbursement for the hospital. Documents level of care and medical necessity concurrently in the patient’s chart to support the clinical review process. Concurrently monitors resources utilization, performing continued stay reviews and assists with managing the length of stay of patients across the continuum. Appropriately identifies and refers cases to the Physician Advisor to validate level of care based on medical necessity to support timely progress of patients along the continuum. Concurrently communicates clinical information to payors; severity of illness, intensity of service and plan of care. Functions as a resource to members of the health care team for payor requirements, ensuring optimal use of patient health care benefits. Maintains current and accurate knowledge regarding commercial and government payors and facilitates communication between hospital and payors as appropriate. Proactively participates in process improvement initiatives with the use of data, trends and reports, working with a variety of departments and multi-disciplinary staff. Works with Utilization Leadership to identify potential problems, recommend solutions and work toward resolution. Collaborates with nursing, physicians, admissions, verification team, care management, compliance, coding, and billing staff to answer clinical questions related to medical necessity and patient status Assists in identifying and providing orientation, training, and competency development for Utilization Review RNs on an ongoing basis REQUIRED QUALIFICATIONS: Required Degree: Diploma or Associate’s Degree in Nursing Required Certification/Licensure: Licensed in New York State as a Registered Nurse PREFERRED QUALIFICATIONS: Minimum five (5) to eight (8) years clinical experience; utilization management/review experience Bachelor’s Degree in Nursing from an accredited school Ability to easily navigate Epic EMR EDUCATION: 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: $86,528.00 - $118,976.00 CITY: Rochester POSTAL CODE: 14621-3038 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.