Utilization Review Nurse

Job Description

RN - Utilization Review

Location: New York, NY 10004

Contract: 13 weeks

Schedule: 3 Days/Week | 11.5 Hours/Day

Shift Time: 9:00 AM-5:00 PM

Guaranteed Hours per Week: 34.5

Pay: Local: $60 to $63/hourly on W2

Travel: $2300 to $2500/ Gross weekly

Job Summary

Pride Health is hiring an experienced RN - Utilization Review for a contract opportunity in New York, NY. The ideal candidate will have experience in non-acute utilization review , along with strong community nursing and quality improvement skills.

Responsibilities

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• Perform utilization review activities in a non-acute healthcare setting.
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• Apply nursing knowledge to support appropriate utilization of healthcare services.
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• Participate in community nursing-related activities.
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• Support quality improvement initiatives.
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• Review clinical information and contribute to appropriate care planning and service utilization.
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• Maintain accurate and timely documentation in accordance with applicable requirements.
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Requirements

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• 1 year of non-acute utilization review experience – required.
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• RN experience preferred.
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• Active New York State RN License required.
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• Primary Source Verification required.
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• AHA BLS certification required.
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• Bachelor’s Degree required.
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• Strong community nursing skills.
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• Experience with quality improvement.
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• Ability to read, write, and speak English.
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Preferred Qualifications

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• Experience in community or home-based healthcare settings.
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• Experience with utilization review and care coordination.
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• Strong clinical documentation and communication skills.
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• Experience supporting quality improvement initiatives.
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Pride-Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.

Equal Employment Opportunity

Pride-Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment

Pride-Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations

We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates : Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.