• Utilization Review Nurse

    Location US-NY-New York
    Posted Date 2 weeks ago(1/2/2019 9:33 AM)
    Job ID
    2018-12467
    # Positions
    1
    Facility
    ArchCare Community Life
    Experience (Years)
    5
    Category
    Administrative
    Work Days Per Week
    5
    Shift
    D
    Shift Start Time
    9
    Shift End Time
    5
    Type
    Full-Time
    # Hours
    35
  • Overview

    The purpose of this position is to ensure that Archcare Advantage members obtain timely, cost-effective, quality care in the appropriate setting. The primary role of the Utilization Review (UR) Nurse is to provide clinical support to the Clinical Services Department and Medical Director to assure that our members receive all appropriate medical services in compliance with medical and regulatory guidelines. Responsibilities include, but are not limited to, review and authorization of Outpatient Services. review of requests for pre-authorization of elective admission and procedures. inpatient admission review. review of continuing stay and discharge planning. and coordination of care and services of select member populations with common chronic conditions. In all areas, the UR Nurse is charged with managing the delivery of care in an effective, professional and compassionate manner.

    Responsibilities

    Qualifications

    Experience Requirements

    License Requirements

    Skill Requirements

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