Clinical Review Specialist

7 days ago


Newburgh, Indiana, United States Montefiore St. Luke's Cornwall Full time
Job Summary:

As a Clinical Review Specialist - RN at Montefiore St. Luke's Cornwall, you will utilize your clinical expertise to provide thorough reviews to insurance carriers, adhering to nationally recognized criteria. You will work collaboratively with the healthcare team to ensure accurate documentation supports the level of care required. Your role will also involve coordinating care to prevent delays and performing discharge planning for those needing home care.

Responsibilities:

• Conduct clinical reviews to determine the level of care required
• Collaborate with the healthcare team to ensure accurate documentation
• Coordinate care to prevent delays and ensure seamless transitions
• Perform discharge planning for patients requiring home care

Requirements:

• Graduate of NLN Accredited School of Nursing, BSN preferred
• Current New York State Licensure as a Registered Professional Nurse
• Certification in Case Management required 18 months after eligibility
• Strong clinical, organizational, and interpersonal skills

About Us:

Montefiore St. Luke's Cornwall is a not-for-profit hospital dedicated to serving the healthcare needs of the Hudson Valley community. We are proud to be part of the Montefiore Health System, a leading organization in population health management. Our dedicated staff, modern facilities, and state-of-the-art treatment make us committed to meeting the needs of our community and striving for excellence.

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