Nurse Utilization Review Specialist
4 weeks ago
VNS Health is seeking a skilled Registered Nurse to join our team as a Utilization Review Specialist. In this role, you will play a critical part in ensuring the highest quality of care for our patients.
Job Summary:The Registered Nurse - Utilization Review will be responsible for conducting clinical assessments, collaborating with healthcare teams, and leading quality improvement initiatives to optimize patient outcomes and satisfaction.
Key Responsibilities:- Conduct clinical assessments, including medication reconciliations, post-discharge transitions of care, and emergency department assessments.
- Collaborate with healthcare teams to ensure compliance with regulatory requirements and industry benchmarks.
- Lead quality improvement initiatives to address non-adherence and clinical diagnosis for HEDIS/QARR exclusion.
- Participate in improvement teams and projects to enhance performance, measurement, and documentation.
- Perform audits on medical records and provide guidance to primary care providers on VNS Health Medical Record Documentation Standards.
- License and current registration to practice as a Registered Professional Nurse in New York State.
- Minimum of three years quality improvement experience in a health plan or healthcare setting.
- Excellent oral, written, and interpersonal communication skills, including group facilitation skills.
VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. We are committed to delivering compassionate care, unparalleled expertise, and 24/7 solutions and resources to our neighbors. Our team is dedicated to simplifying the healthcare experience and meeting the diverse and complex needs of those we serve.
Benefits:- Guaranteed hours
- 401k retirement plan
- Employee assistance programs
- Dental benefits
- Vision benefits
- License and certification reimbursement
- Life insurance
- Discount program
- Holiday pay
- Continuing education
- Wellness and fitness programs
- Mileage reimbursement
- Medical benefits
-
Nurse Utilization Review Specialist
1 month ago
Paramus, New Jersey, United States VNS Health Full timeAbout the RoleVNS Health is seeking a skilled Nurse Utilization Review Specialist to join our team. As a key member of our quality improvement team, you will play a critical role in ensuring the highest level of patient care and satisfaction.Key ResponsibilitiesConduct clinical assessments, including medication reconciliations, post-discharge transitions of...
-
Utilization Review Nurse
1 week ago
Paramus, New Jersey, United States VNS Health Full timeUtilization Review Registered NurseVNS Health is seeking a skilled Registered Nurse (RN) to join our team in North Bergen, New Jersey. As a Utilization Review Registered Nurse, you will play a critical role in providing compassionate care and expert services to our community.Key Responsibilities:Investigate and review routine and complex situations to...
-
Clinical Nurse Specialist
4 weeks ago
Paramus, New Jersey, United States VNS Health Full timeJob Title: Clinical Nurse SpecialistVNS Health is seeking a skilled nursing professional to join our team as a Clinical Nurse Specialist. This role involves providing high-quality patient care and supervision to Home Health Aides in a dynamic and fast-paced environment.Key Responsibilities:Monitor and assess the delivery of home health field services to...
-
Diagnostic Imaging Specialist
2 weeks ago
Paramus, New Jersey, United States American Family Care Full timeJob SummaryAs a Diagnostic Imaging Specialist at American Family Care, you will play a critical role in assisting physicians in diagnosing injuries and diseases by performing radiographic and other diagnostic imaging procedures.ResponsibilitiesGreet patients and explain procedures in a compassionate mannerPosition patients appropriately for diagnostic...
-
Senior Procurement Specialist
2 weeks ago
Paramus, New Jersey, United States QISG Full timeJob Title: Senior Procurement SpecialistPhoenix Power Group Inc. (PPG) is a leading Construction Services Company providing Engineering, Procurement and Construction (EPC) services specializing in the installation of utility and industrial process infrastructure including substations, power generation, industrial process facilities, and renewable fuel...
-
Physical Therapist Specialist
2 weeks ago
Paramus, New Jersey, United States Hackensack Meridian Health Full timeJob Summary:At Hackensack Meridian Health, we are seeking a highly skilled Physical Therapist Clinical Specialist to join our team. As a key member of our healthcare team, you will be responsible for providing physical therapy treatment and education to inpatients and outpatients. Your expertise will also be utilized to educate and develop departmental and...
-
Senior Procurement Specialist
2 weeks ago
Paramus, New Jersey, United States QISG Full timeJob Title: Senior Procurement SpecialistPhoenix Power Group Inc. (PPG) is a leading Construction Services Company providing Engineering, Procurement and Construction (EPC) services specializing in the installation of utility and industrial process infrastructure including substations, power generation, industrial process facilities, and renewable fuel...
-
Medical Care Nurse Specialist
2 weeks ago
Paramus, New Jersey, United States VNS Health Full timeJob Title: Medical Care NurseVNS Health is seeking a skilled Registered Nurse to join our team as a Clinic Utilization Review professional in North Bergen, New Jersey.Job Summary:We are looking for a highly motivated and detail-oriented Registered Nurse to resolve grievances, appeals, and external reviews for our VNS Health Plans product lines. The ideal...
-
Access Intake Specialist
3 weeks ago
Paramus, New Jersey, United States Bergen New Bridge Medical Center Full timeJob SummaryWe are seeking a highly skilled Access Intake Specialist to join our team at Bergen New Bridge Medical Center. As an Access Intake Specialist, you will play a critical role in ensuring that patients receive the necessary care and services in a timely and efficient manner.Key ResponsibilitiesHandle telephone inquiries and make decisions regarding...
-
Travel Nurse RN Position
2 weeks ago
Paramus, New Jersey, United States Travel Nurse Source Full timeTravel Nursing OpportunityWe are working with Triage Staffing to find a qualified CVICU RN for a travel nursing position in a Cardiovascular Intensive Care Unit in Paramus, New Jersey.Job DetailsPay Information: $2,503 per weekShift Details: 12H Nights (7:00 PM-7:30 AM), 36 hours per weekLength: 13 weeksAbout the PositionAs a CVICU RN, you will be...
-
Travel Nurse RN
1 week ago
Paramus, New Jersey, United States Travel Nurse Source Full timeTravel Nursing OpportunityWe are working with Triage Staffing to find a qualified CVICU RN for a travel nursing position in a Cardiovascular Intensive Care Unit in Paramus, New Jersey.Job DetailsPay Information: $2,503 per weekShift Details: 12H Days (7:00 AM-7:30 PM), 36 hours per weekLength: 13 weeksAbout the Position:As a CVICU RN, you will be responsible...
-
Medical Billing Specialist
10 hours ago
Paramus, New Jersey, United States New Bridge Medical Center Full timeJob SummaryWe are seeking a highly skilled Medical Billing Specialist to join our team at New Bridge Medical Center. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely billing and reimbursement for our patients.Key ResponsibilitiesEdit and correct claims in the Claims Administrator system to ensure accurate...
-
Lead Nurse
1 month ago
Paramus, New Jersey, United States Restore Hyper Wellness L5 Be Well Full timeAbout the RoleWe are seeking a highly skilled and experienced Registered Nurse to join our team as a Lead Nurse - Preventative Health Specialist. As a key member of our team, you will be responsible for leading a team of Registered Nurses and providing exceptional patient care in a preventative health setting.Key ResponsibilitiesAdminister IV Drip Therapy...
-
Access Intake Specialist
4 weeks ago
Paramus, New Jersey, United States Bergen New Bridge Medical Center Full timeJob SummaryWe are seeking a highly skilled Access Intake Specialist to join our team at Bergen New Bridge Medical Center. As a key member of our intake team, you will be responsible for handling telephone inquiries, making decisions regarding referrals, and educating clients about our services.Key ResponsibilitiesHandle telephone inquiries and make decisions...
-
Travel Nurse RN
10 hours ago
Paramus, New Jersey, United States Travel Nurse Source Full timeTelemetry RN Job OpportunityWe are working with Triage Staffing to find a qualified Telemetry RN for a 13-week assignment in Paramus, New Jersey.Job DetailsShift: 12H Days (7:00 AM-7:30 PM)Hours: 36 hours per weekLength: 13 weeksAbout the PositionAs a Telemetry RN, you will be responsible for providing high-quality patient care in a fast-paced hospital...
-
Travel Nurse ICU Specialist
5 days ago
Paramus, New Jersey, United States TotalMed Staffing Full timeJob Title: Travel Nurse ICU SpecialistTotalMed Staffing is seeking a skilled Travel Nurse ICU Specialist to join their team for a travel nursing assignment in Paramus, New Jersey.Job Details:Specialty: ICU - Intensive Care UnitDiscipline: RNDuration: 13 weeksShift: 12 hours, nightsEmployment Type: TravelWe are looking for a dedicated and compassionate...
-
Payroll Specialist
3 weeks ago
Paramus, New Jersey, United States Company Full timePayroll Specialist Job DescriptionWe are seeking an experienced payroll professional to join our organization. The Payroll Specialist will be responsible for the day-to-day administration of payroll processing.Key Responsibilities:Manage the timely and accurate multi-state, bi-weekly payroll process for employees.Review system input of all employee...
-
Security Specialist
2 weeks ago
Paramus, New Jersey, United States Security Industry Specialists Full timeAbout this Position:We are seeking a highly skilled Security Specialist to join our team at Security Industry Specialists, Inc. (SIS). As a Security Specialist, you will play a critical role in ensuring the safety and security of our clients' employees and guests.Key Responsibilities:Provide a safe and professional work environment for clients' employees and...
-
Travel Nurse RN
1 week ago
Paramus, New Jersey, United States Travel Nurse Source Full timeAbout the PositionWe are seeking a highly skilled ICU/Critical Care RN to join our team at a top-rated hospital in Paramus, New Jersey. As a CVICU RN, you will provide exceptional care to patients with life-threatening heart conditions, utilizing your expertise in cardiac care and recovery.ResponsibilitiesProvide high-quality patient care to patients with...
-
Nurse Specialist
1 day ago
Paramus, New Jersey, United States Aequor Technologies Full timeJob OpportunityWe are seeking a skilled Nurse Specialist to join our team at Aequor Technologies.Job Summary:This is a 13-week contract position for a Registered Nurse (RN) with experience in Labor and Delivery.Key Responsibilities:Provide high-quality patient care in a fast-paced environment.Collaborate with healthcare teams to ensure seamless patient...