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Clinical Utilization Review Registered Nurse

2 months ago


North Bergen, United States VNS Health Full time

VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job.

Job Description & Requirements
  • Specialty: Utilization Review
  • Discipline: RN
  • Start Date: ASAP
  • Duration: Ongoing
  • Employment Type: Staff

We are looking for a Registered Nurse to resolve grievances, appeals, and external reviews for VNS Health Plans. This position involves ensuring regulatory compliance, maintaining accurate records, and creating correspondence communicating outcomes. This role also involves reviewing prior authorizations, coordinating external case reviews, and collaborating with various departments and external entities. Applicants must have a Bachelor's or Master's Degree in Nursing, a current RN license in New York State, and at least three years of professional experience in healthcare. Proficient verbal/written communication skills, computer skills, and the ability to work in a fast-paced environment are also required. If you are looking for a role that offers professional growth, competitive benefits, and the opportunity to make a difference in healthcare, apply now.