Job Description

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Registered Nurse Clinical Utilizati...

Ref: 309656
Type: Direct Hire
Location: Bronx, NY

Industry: Healthcare
Job Level: Experienced Non-Manager
Pay: $95,000.00 - 110,00.00

Opportunity Description

Do you have a passion for caring for older adults? If so, you have found the right place to continue your career! Join our compassionate and dedicated team and make a difference in the lives of our members.

The Clinical Utilization Registered Nurse works directly with the Clinical Utilization Director in supporting clinical decisions for hospital and skilled nursing admissions, decisions on Personal Care Aide services for high hour cases, and decisions for high dollar medical equipment.

Job Duties

The Clinical Utilization Registered Nurse is responsible for collaborating with Care Management in order to support the defense of fair hearings, PCA high hour decisions, and MAP admissions.

Education

Current valid New York State license as Registered Professional Nurse.

Bachelor’s Degree in nursing required.

Experience & Skills Required

Minimum of two (2) years in managed care setting, Care Management, Utilization Management and/or Grievance and Appeals experience.

Demonstrated knowledge of Medicare and Medicaid regulations. Strong analytical skills.

Effective oral and written communication skills. Strong organizational skills.

Thorough knowledge of personal computer, especially proficiency with Microsoft Word, PowerPoint, and Excel.

Ability to work and manage problems independently.

Benefits

Our client offers an excellent and comprehensive benefits package which includes:

HEALTH & INSURANCE BENEFITS

Medical and Prescription Drug

Company-Paid Dental

Company-Paid Vision

Company-Paid Life Insurance and Accidental Death & Dismemberment

Company-Paid Short-Term Disability

Company-Paid Long-Term Disability

Health Care Flexible Spending Account

Dependent Care Flexible Spending Account

Employee Assistance Plan

Additional Life Insurance options for the employee and family members

Additional Disability options

403(b) Plan, with a generous employer contribution

TIME OFF BENEFITS

Holidays

Personal Days

Sick Days

Vacation

ADDITIONAL BENEFITS

Bereavement Days

Cell Phone Discount Plan

Commuter Plan

Jury Duty Days

Marriage Days

Pet Insurance Discount Plan

Tuition Assistance

Wellness Programs

Years of Service Awards

Other Information

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