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Rochester Regional Health

Integrated system of hospitals, clinics, labs

Care Facilitator

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Part-time$70k - $95k

About the Job

Requirements

  • A diploma from an accredited nursing school program or an associate's degree is required.
  • Three years of acute hospital care experience is required.
  • A New York State Registered Nurse license is required.

Responsibilities

  • Conduct clinical reviews using InterQual criteria to determine appropriate patient level of care, document medical necessity, and support reimbursement.
  • Monitor resource utilization through continued-stay reviews, manage length of stay, and coordinate with Physician Advisors for complex cases.
  • Serve as a liaison between the hospital and payors, ensuring accurate communication of clinical information, supporting appeals, and optimizing benefit use.
  • Collaborate with care teams to resolve barriers to care, participate in daily huddles, and use data to identify opportunities for process improvement.
  • Plan with the health care team to ensure patient needs are met and care delivery is coordinated across the continuum.
  • Identify and work to eliminate or minimize system variation and service delivery barriers that prevent optimal patient outcomes within the expected time frame and with efficient use of resources.
  • Carry out utilization management, discharge planning, care coordination, and referrals to other levels of care.
  • Promote interdisciplinary collaboration and service excellence as part of the interdisciplinary team.
  • Facilitate assignment of level of care, consider payer requirements, and respond to avoid adverse financial consequences to the patient and hospital.
  • Model the organization's Brand Promise and Core Values to provide customer service.

Desired Qualifications

  • Case Management or Utilization Management experience is preferred.
  • A bachelor's degree is preferred.

About the Company

Rochester Regional Health

Integrated system of hospitals, clinics, labs

Rochester Regional Health is a regional health system that provides integrated medical care across Western New York and beyond, with 500+ locations, including 8 hospitals, clinics, rehabilitation centers, senior services, behavioral health, and clinical trials. Patients access care through its network of hospitals, clinics, rehab centers and labs, with care coordinated across locations and teams handling prevention, diagnosis, treatment, rehabilitation and ongoing support. The organization stands apart by offering a wide range of services under one umbrella, enabling continuous, coordinated care within a single system, with a focus on neighbor-driven, community-based, real-life care. Its goal is to help the community stay healthy and live fulfilling lives by delivering accessible, comprehensive, patient-centered health care for people at every age and stage.

Company size
10,001+
Company stage
Grant
Total funding
$600K
Headquarters
Rochester, NY
Founded
Not listed

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