Location: New York, NY
extra help to stay healthy and live life to its fullest as more than just a job. To us, it's a privilege and our calling. Benefits/Perks: Includes accrued vacation days, sick days, and holidays. Participation in 403 (b)Voluntary Benefits: Short Term Disability, Life Insurance, Cancer Insurance, Pet Insurance Discounted memberships: Plum Benefits, NYSC Gym Pay for work-related eligible commuter expenses with pre-tax dollars Responsibilities Responsibilities: Conduct initial inpatient review and determine the appropriateness of admission, anticipated length of stay and potential discharge needs.
Document inpatient reviews in the computer system including diagnosis, procedures, attending
physician, treatment plan, anticipated length of stay, and the Interqual Criteria used to justify continued stay. Actively participate in the discharge planning process with the facility discharge planner to ensure timely discharge, appropriate follow up and continuity of care.
Review and evaluate all requests for office visits, home care, outpatient procedures, ambulatory surgery and transportation according to MLTC's UM guidelines and the standards specified in the MLTC Utilization Manual. Assist members in accessing services, including making appointments for members when appropriate and providing patient teaching and support to facility compliance with treatment. Perform follow-up
phone calls to facilitate obtaining of documents for any member visit or admission to Facilities, ER, and Hospital.
Job Type: Full Time Salary: $44.84 - $56.05 per hour Qualifications Education: Associate Degree in Nursing or certification equivalent BSN preferred Qualifications: 3 years of nursing experience in adult acute care setting For more details: jobs-search. org/insurance/utilization-review-nurse-new-york_i1950048641
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