UAS RN
2 weeks ago
Assesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages requests for services from providers, members, and care management team and renders clinical determinations in accordance with VNS Health Plans policies as well as applicable state and federal regulations. Delivers timely notification detailing VNS Health clinical decisions. Coordinates with VNS Health Plans team, subject matter experts, physicians, member representatives, and discharge planners to ensure care is appropriate, timely and cost effective. Works under general supervision.
Compensation:
$85,000.00 - $106,300.00 Annual
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
- Interdisciplinary network of colleagues through the VNS Health Social Services Community of Professionals
What You Will Do
- Conducts comprehensive review of all components related to requests for services which includes a clinical record review and interviews with members, clinical staff, medical providers, paraprofessional staff, caregivers and other relevant sources as necessary.
- Utilizes VNS Health Plans and state approved assessment questionnaire, guidelines and documentation as well as interviews with members, family, and care providers in decision-making.
- Performs in-home assessment for members who have identified significant changes in condition since last in-home assessment; provides comprehensive review and determination of member’s needs, including completion of UAS assessment questionnaire, tasking tool, and a projected service plan. Visits include all areas serviced by VNS Healt including upstate and downstate counties.
- Performs in-home assessment on members to determine the appropriate service plan, including completion of UAS assessment questionnaire, tasking tool, and a projected service plan. Visits include all areas serviced by VNS Health.
- Examines standards and criteria to ensure medical necessity and appropriateness of service, admissions, and lengths of stay. Performs prior authorization and concurrent reviews to ensure service and covered benefit is medically necessary and being conducted in the right setting.
- Uses effective standards of review, service determination, resource management, education and related interventions to promote improved quality of care and/or life, ensure cost effective medical outcomes, prevent hospitalizations when possible, prevent complications in members under our care when possible, provide continuity of care, and ensure appropriate levels of care are received. .
- Ensures compliance with state and federal regulatory standards and VNS Health policies and procedures.
- Identifies opportunities for alternative care options and contributes to the development of a safe member centered service plan
- Issues request determinations, including Notice of Action letters, and other forms of communication to members and providers.
- Maintains current knowledge of organizational or state wide trends that affect member eligibility and the need for issuance of Notices of Action.
- Ensures all records/logs related to decision requests, Notices of Action, and other communications required by state or federal regulations are documented and saved in the member’s record.
- Evaluates and analyzes utilization trends/issues and identifies opportunities for better coordination of member services.
- Coordinates with other departments, e.g. Care Management, Legal Affairs, Grievance and Appeals, Compliance, Membership Eligibility Unit, Quality as needed.
- Participates in approval for out-of-network services when member receives services outside of VNS Health network services.
- Keeps current with all health plan changes and updates through on-going training, coaching and educational materials.
- Participates in special projects and performs other duties as assigned.
Qualifications
License/Certifications
- Current license to practice as a Registered Professional Nurse in New York State required. Certified Case Manager preferred
Education
- Bachelor’s degree or Master’s degree in nursing preferred
Work Experience
- Minimum two years of clinical assessment, homecare or hospital experience required. Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills required
- Demonstrated strong relationship management skills, including a high degree of psychological sophistication and non-aggressive assertiveness required
- Demonstrated successful conflict management skills and negotiation of “win-win” solutions required Working knowledge of Microsoft Excel, Power-Point, and Word required
- Knowledge of Medicaid and/or Medicare regulations required Working Knowledge of UAS-NY
-
#21724: RN – UAS FIELD NURSE
7 days ago
Utica, NY 13502, USA, United States Med-Scribe, Inc. Full timeAre you ready to embark on a mission where every assessment visit is an opportunity to make a real difference? Join us as a UAS Field Nurse in Utica, NY, and become part of an elite team of healthcare heroes dedicated to transforming lives! As an Ass RN, Field, Nurse, Healthcare, Staffing
-
UAS RN
7 days ago
Manhattan, New York, NY, USA, United States VNS Health Full timeOverviewAssesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages requests for services from providers, members, and care management team and renders clinical determinations in accordance with VNS Health Plans policies as well as applicable state and federal regulations. Delivers timely...
-
UAS RN
2 weeks ago
New York, NY, United States VNS Health Full timeOverviewAssesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages requests for services from providers, members, and care management team and renders clinical determinations in accordance with VNS Health Plans policies as well as applicable state and federal regulations. Delivers timely...
-
Hempstead, NY 11550, USA, United States Med-Scribe, Inc. Full timeYou will complete an interview with a patient and finalize a UAS assessment to determine eligibility for Long Term Care services. You will be scheduled for a maximum of 2-3 initial and/or reassessment appointments daily within your travel area (depen RN, LTC, Evaluator, Healthcare, Staffing
-
Local Contract Nurse RN
3 days ago
Manhattan, NY, United States Pyramid Consulting Full timePyramid Consulting is seeking a local contract nurse RN Home Health for a local contract nursing job in Manhattan, New York.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNStart Date: 05/31/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Local ContractPerks: Benefits include - Health, Medical, Vision insurance...
-
Local Contract Nurse RN
5 hours ago
Manhattan, NY, United States Pyramid Consulting Full timePyramid Consulting is seeking a local contract nurse RN Home Health for a local contract nursing job in Manhattan, New York.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNStart Date: 05/31/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Local ContractPerks: Benefits include - Health, Medical, Vision insurance...
-
UAS ASSESSMENT NURSE, LTSS
7 days ago
New York, NY 10007, USA, United States AdvantageCare Physicians Full timeSummary of Job:Assess eligibility of members in need of community based long term support services (CBLTSS). Conduct UAS assessment in the members home or by telehealth (under NY State's regulations), and at skilled nursing facilities. Consult with health care providers to support assessment outcomes. Conduct needs assessment utilizing the UAS-NY/DOH tool to...
-
PER DIEM VISITS NURSE
4 days ago
, NY, United States Soloh Partners Inc Full timePosition: Per Diem Visist Nurse (RN)Location: Brooklyn or ManhattanVisit Duration: 1 Hour or LessType of Visists: Wound Care or IVF InjectionsPay Per Visit: $50Overview: Registered Nurse (RN) provides in-home patient services for resitently hospital discharged patients and/or patients receiving IVF treatments. Enter visit notes within the managed care system...
-
ASSESSMENT NURSE
4 days ago
, NY, United States NYC Health Hospitals Full timeMetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned...
-
PER DIEM RN
4 days ago
, NY, United States Polaris Healthcare Full timePolaris Healthcare - RN NEEDED FOR PER DIEM;· NYS Registered Nurse· This is a position that would go between our facilities in the region· Must have recent experience performing and entering UAS assessments for adult patients (preferably in an assisted living setting)o Assessments must be done in...
-
RN UAS
7 days ago
New York, NY 10261, USA, United States ProMed Staffing Resources Full timeProMed Staffing Resources is hiring for several Home Care Registered Nurses (RN) roles at reputable healthcare facilities in Manhattan. This is an ongoing hybrid position with flexible schedule. Applicants should have at least two years of recent RN RN, Evaluation, Healthcare, Staffing, Health, Valuation
-
RN UAS
3 weeks ago
New York, NY 10261, USA, United States ProMed Staffing Resources Full timeProMed Staffing Resources is hiring for several Home Care Registered Nurses (RN) roles at reputable healthcare facilities in Bronx. This is an ongoing hybrid position with flexible schedule. Applicants should have at least two years of recent RN expe RN, Evaluation, Healthcare, Staffing, Health, Valuation
-
Per Diem Rn
2 weeks ago
Westchester County, NY, United States Polaris Healthcare Full timeRN NEEDED FOR PER DIEM WORK; - NYS Registered Nurse - This is a position that would go between facilities in the region - Must have recent experience performing and entering UAS assessments for adult patients (preferably in an assisted living setting) - Assessments must be done in person during hours that are acceptable to the home/residents - Paperwork can...
-
REGIONAL ASSESSMENT NURSE
4 days ago
, NY, United States Marquis Home Care Full timeMarquis Home Care - Seeking full time assessment RN for assessment work in Westchester, Bronx and Queens.Assessment Nurse will be responsible for the completion of assessments including all required paperwork while ensuring timely submission.Requirements:Current and Valid NYS RN LicenseExperience with computers including electronic documentation...
-
Local Contract Nurse RN
8 hours ago
The Bronx, NY, United States Pyramid Consulting Full timePyramid Consulting is seeking a local contract nurse RN Home Health for a local contract nursing job in Bronx, New York. Job Description & Requirements Specialty: Home Health Discipline: RN Start Date: 05/31/2024 Duration: 13 weeks 40 hours per week Shift: 8 hours, days Employment Type: Local Contract Perks: Benefits include - Health, Medical, Vision...
-
Local Contract Nurse RN
8 hours ago
Bronx, NY, United States Pyramid Consulting Full timePyramid Consulting is seeking a local contract nurse RN Home Health for a local contract nursing job in Bronx, New York.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNStart Date: 05/31/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Local ContractPerks: Benefits include - Health, Medical, Vision insurance and...
-
Local Contract Nurse RN
3 days ago
Queens, NY, United States Pyramid Consulting Full timePyramid Consulting is seeking a local contract nurse RN Home Health for a local contract nursing job in Queens, New York.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNStart Date: 05/31/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Local ContractPerks: Benefits include - Health, Medical, Vision insurance and...
-
Local Contract Nurse RN
3 days ago
Bronx, NY, United States Pyramid Consulting Full timePyramid Consulting is seeking a local contract nurse RN Home Health for a local contract nursing job in Bronx, New York.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNStart Date: 05/31/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Local ContractPerks: Benefits include - Health, Medical, Vision insurance and...
-
Local Contract Nurse RN
3 days ago
Brooklyn, NY, United States Pyramid Consulting Full timePyramid Consulting is seeking a local contract nurse RN Home Health for a local contract nursing job in Brooklyn, New York.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNStart Date: 05/30/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Local ContractPerks: Benefits include - Health, Medical, Vision insurance and...
-
Local Contract Nurse RN
2 days ago
Brooklyn, Bronx,, NY, United States Pyramid Consulting Full timePyramid Consulting is seeking a local contract nurse RN Home Health for a local contract nursing job in Brooklyn, Bronx,, New York.Job Description & RequirementsSpecialty: Home HealthDiscipline: RNStart Date: 05/27/2024Duration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Local ContractPerks: Benefits include - Health, Medical, Vision...
