Registered Nurse

2 weeks ago


Edgewater, New Jersey, United States VNS Health Full time
Job Title: Registered Nurse - Utilization Review

VNS Health is seeking a skilled Registered Nurse to join our team as a Utilization Review Specialist. In this role, you will be responsible for conducting clinical assessments, collaborating with healthcare providers, and ensuring compliance with regulatory requirements.

Key Responsibilities:
  • Conduct clinical assessments, including medication reconciliations, post-discharge transitions of care, and emergency department assessments.
  • Collaborate with healthcare providers to ensure compliance with DOH/CMS/NCQA requirements.
  • Develop and implement quality improvement initiatives to improve patient outcomes, satisfaction, and cost-effectiveness.
  • Participate in performance improvement teams and projects to identify areas for improvement and develop corrective action plans.
  • Conduct audits of patient care records to ensure compliance with regulatory requirements and identify areas for improvement.
Requirements:
  • 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 communication and interpersonal skills, including group facilitation skills.
  • Knowledge of basic performance improvement tools and methodologies.
About VNS Health:

VNS Health is one of the nation's largest nonprofit home and community-based health care organizations. We are committed to delivering high-quality, patient-centered care to our communities. Our team of healthcare professionals is dedicated to improving the health and well-being of our patients and their families.

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


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