UTILIZATION REVIEW COORDINATOR
2645
Under general supervision, an employee in this class
coordinates all utilization review activities in the Suffolk County Nursing
Home, Department of Health Services.
Utilization review is defined as the initial and continuing medical
assessment of each patient to determine the level of care needed by that
patient, and the recommendation of discharge for those patients no longer
needing the level of care provided by the facility. The incumbent serves on the Nursing Home's
Utilization Review Committee, presides at Committee meetings and provides the
Committee with needed information. The
primary emphasis of the work is on overseeing and coordinating the Utilization
Review Program, from pre-admission assessments to discharge planning. Supervision is received from the Nursing Home
Administrator through conferences, staff meetings and the attainment of desired
results. Does related work as required.
TYPICAL WORK ACTIVITIES
Develops, implements and monitors the utilization review
program at the Suffolk County Nursing Home;
Supervises
the use of medical assessment forms in the facility and periodically conducts
in-service training to ensure that nurses make proper use of same;
Performs
nursing assessments on patients seeking admission to the Nursing Home, and
makes appropriate recommendations to the Admissions Committee;
Coordinates
annual Medical Care Evaluation Studies, presents regular status reports to the
Utilization Review Committee and assists technical personnel in the
documentation and reporting of such studies;
Assists in
discharge planning, following guidelines defined in the Utilization Review
Plan;
Maintains
records and prepares reports for the Utilization Review Committee;
Establishes
policy and develops procedures for the Utilization Review program, with the
assistance of the Utilization Review Committee and the Administrator.
FULL PERFORMANCE KNOWLEDGES, SKILLS, ABILITIES AND
PERSONAL CHARACTERISTICS
Thorough knowledge of local, State and federal
requirements governing utilization review activities in a skilled nursing
facility; thorough knowledge of the principles and practices of modern
professional nursing; good knowledge of the structure and proper use of patient
medical records; good knowledge of other long-term nursing facilities on Long
Island; ability to coordinate and integrate the various aspects of the
Utilization Review program efficiently and effectively; ability to assess the
level of care needed by patients and prospective patients; ability to perform
research and present information clearly and logically; ability to establish
and maintain effective working relationships with co-workers, patients and
employees of other facilities in the area; ability to express oneself clearly
and concisely, both orally and in writing; physical condition commensurate with
the demands of the position.
MINIMUM QUALIFICATIONS
OPEN
COMPETITIVE
Either:
(a)
Possession of a Registered Nurse's license issued by the New York State
Education Department, and five (5) years of professional nursing experience in
a long-term care facility, two (2) years of which must have been in utilization
review activities; or,
(b) Graduation
from a college with federally-authorized accreditation or registration by NY
State with a Bachelor's degree in Nursing, possession of a Registered Nurse's
license issued by the New York State Education Department and three (3) years
of professional nursing experience in a long-term care facility, two (2) years
of which must have been in utilization review activities; or,
(c) An
equivalent combination of education and experience as defined by the
limits of (a) and (b).
NECESSARY SPECIAL REQUIREMENTS
l. At the
time of appointment, and during employment in this title, employees will be
required to possess a valid license to operate a motor vehicle in New York
State.
2. Appointees
must maintain a valid Registered Nurse's license throughout their employment in
this title.
10/1/84
SUFFOLK COUNTY
Competitive
Review 7/23/15