Remote utilization review nurse jobs in New Rochelle, New YorkCreate job alerts

RN UAS Nurse openings with a major health insurance / managed care company based in the Bronx, Brooklyn, or Manhattan, NY area! Starting ASAP!! Apply now with Chris M. at A-Line! Job Summary: Complete in-person UAS assessments with members in their homes or living facilities along with necessary documentation. * combination of remote work with field visits in the Bronx, Brooklyn, or Manhattan, NY area. Job Duties: RN must prep for the visit the morning of or afternoon before (Review of EMR and previous assessments)• Be prepared to use critical thinking and problem solving skills.• Travel to the members' homes to conduct the visit and assessment,• Accurately document assessment results according to the provided documentation template• Review all documentation and utilize Lenavi to identify inconsistencies that need to be corrected or validated.• Complete and load supplemental tools and documents.• Each day varies, nurse needs to be flexible with schedule and process changes, critical thinking and problem solving, prepared for travel, weather variability. What previous job titles or background work will in this role? Experience as a UAS Assessment nurse Individuals that have MLTC, MAP or Maximus experience Shift Times: Mon-Fri 8:30am-5pm with a 1-hour lunch break. OT may be required Pay Rate: $52 - $58 hourly (determined on experience) plus mileage reimbursement Required Skills: · Licenses/Certifications: Current New York State RN license – no restrictions on license · Clinical background – RN experience (1+ years) · Case Management or UAS Experience highly preferred · Experience working with Managed Care plans highly preferred · Documentation skills and good computer skills needed · Must have Computer literacy, including with Microsoft Programs like Excel, Outlook, and Word Why Apply with A-Line? · Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability · 401k after 1 year of employment: With employer match and profit sharing · GREAT Hours! Monday through Friday, 40 hours per week · Competitive Pay Rate INDSV Keywords: UAS, URAC, CCM, BSN, ADN, ASN, Case Manager, Case Management, InterQual, Medicare, Medicaid, CMS Guidelines, Utilization Review, Utilization Management, Registered Nurse, MCO, RN, Nurse, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare, Inbound Calls, Outbound Calls, URAC, CCM, BSN, ADN, ASN, Case Manager, Case Management, InterQual, Medicare, Medicaid, CMS Guidelines, Utilization Review, Utilization Management, Registered Nurse, MCO, RN, Nurse, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare, Inbound Calls, Outbound Calls, URAC, CCM, BSN, ADN, ASN, Case Manager, Case Management, InterQual, Medicare, Medicaid, CMS Guidelines, Utilization Review, Utilization Management, Registered Nurse, MCO, RN, Nurse, Managed Care, Medical Claims, Appeals, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Healthcare, Inbound Calls, Outbound Calls. Job Duties: RN must prep for the visit the morning of or afternoon before (Review of EMR and previous assessments)• Be prepared to use critical thinking and problem solving skills.• Travel to the members' homes to conduct the visit and assessment,• Accurately document assessment results according to the provided documentation template• Review all documentation and utilize Lenavi to identify inconsistencies that need to be corrected or validated.• Complete and load supplemental tools and documents.• Each day varies, nurse needs to be flexible with schedule and process changes, critical thinking and problem solving, prepared for travel, weather variability.