Get Hired Faster With COMPANY_NAME!
Don't you ever think you landed here by any accident, You are here because you are searching for something bigger. You know what?
- A better Job
- A better Future
- A better Knowledge
- A better Paycheck
- A greater Path to walk on.
And COMPANY_NAME is here to give you exactly what you've been missing for so long. The reality is that most job seekers chase job postings, but successful job seekers attract job offers by chasing the accurate information. Therefore, that's the shift COMPANY_NAME is going to help you make. Here are the top 10 ideas to up-skill yourself, so lean in to begin:
1: COMPANY_NAME Smart Tools and Direct Employer Connections Help Speed Up Your Hiring Process
COMPANY_NAME is a career-changing advantage that most seekers never get access to. Imagine...
- Instead of applying for job after job and still not getting any callbacks, you suddenly bump into a tool that can do the heavy lifting for you.
- Instead of wondering, "What do employers actually want?", you are getting insights straight from the employer's desk.
- Instead of hoping your resume gets noticed, it’s kept on the table of decision-makers who are hiring right now.
That's the difference COMPANY_NAME makes. Our tools will let you reach employers directly, which automatically speeds up your hiring process.
2: With Better Matches, Real-time Job Alerts, and Direct Employer Responses, COMPANY_NAME Helps Many Candidates Secure Interviews and Job Offers Within 15 to 30 Days!
How does COMPANY_NAME make this possible?
On COMPANY_NAME, you get notified for roles aligned with your profile right from the start. When an employer posts a role that matches your qualifications and skills, you’ll know first. When you apply early, your chances of getting noticed and shortlisted increase by 20%.
COMPANY_NAME also offers direct employer responses—no more waiting for weeks. Here you engage with hiring managers who are actively looking for candidates.
When all these features combine in one place, you move from your first match to your first interview within days. And ultimately, from application to offer—all within 15 to 30 days!
3: The Type of Resume You Need to Get Priority Placement
With COMPANY_NAME, you don’t just need a resume—you need a strategy. A system that pushes your name to the right tables. We’ll show you exactly how the most successful candidates take initiative and get noticed.
4: Browse Full-Time, Part-Time, and Freelancing Roles With COMPANY_NAME
The job market isn’t one-size-fits-all—and your career shouldn’t be either. COMPANY_NAME gives you access to a wide range of opportunities including full-time, part-time, and freelancing roles all in one place.
5: COMPANY_NAME Helps You Grow Your Career
COMPANY_NAME provides insights, tools, and role-matching that help you find the right direction, the right skills, and the opportunities aligned with your ambition.
6: The Easiest Way To Find A Job
COMPANY_NAME cuts the noise, the endless scrolling, and the confusion. With accurate matches, direct employer connection, and real-time updates, you get a clear and simple path from application to interview.
7: Find Roles That Offer Growth, Culture & Benefits
COMPANY_NAME helps you find roles where you grow, feel supported, and thrive—not just survive. With us, you discover opportunities that elevate your professional life.
8: Get Support With Resume, Interviews & Career Planning
COMPANY_NAME provides expert guidance on resumes, interviews, and planning so employers instantly recognize your strengths and value.
9: Your Future Starts Today
COMPANY_NAME gives you everything you need—tools, guidance, and opportunities—to step forward confidently and begin a new chapter where your potential is seen and supported.
10: Get Hired Within 15 to 30 Days With COMPANY_NAME
COMPANY_NAME follows a smart, strategic, and proven approach that gets your profile noticed faster and moves you toward interviews and offers within 15 to 30 days.
Utilization Review Nurse- Care Coordination Department
Description
Position at Vassar Brothers Medical Center Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities. Northwell is New York State’s largest private employer with over 104,000 employees — including members of Northwell Health Physician Partners — who are working to change health care for the better.Summary
The Utilization Review Nurse is responsible for conducting timely, accurate, and comprehensive clinical reviews to ensure that patients receive the appropriate level of care in accordance with regulatory, payer and organizational guidelines. The Utilization Review Nurse applies evidence-based criteria to evaluate medical necessity and collaborates with physicians and interdisciplinary team members to reduce denials and ensure compliance with CMS and payer regulations.
Responsibilities
1. Clinical Review & Level of Care Determination
- Performs initial, concurrent, and discharge utilization reviews to determine the appropriate patient status (inpatient, observation, outpatient).
- Applies InterQual, MCG, or payer-specific criteria in accordance with CMS regulations and the Two-Midnight Rule.
- Collaborates with admitting providers to obtain timely admission orders and correct patient status when discrepancies arise.
- Ensures MOON, IMN, HINN (etc.) notices are issued and documented per policy.
2. Payer Communication & Authorization Management
- Conducts timely payer notifications with complete reviews and all supporting clinical documentation via fax or payer portal.
- Provides clinical updates and facilitates peer-to-peer reviews as required.
- Maintains documentation of all payer interactions in Cerner.
- Securely maintains all relevant login credentials for all payer portals.
- Demonstrates proficiency in navigating payer portals to efficiently retrieve and submit required data.
3. Collaboration with Clinical Team
- Discusses cases with the attending MD when a clinical review does not meet inpatient medical necessity at the first-level review to obtain additional clinical information and documentation to support inpatient level of care; if the case still does not meet criteria, sends it to the Physician Advisor for a second-level review.
- Forwards cases requiring secondary physician review to the appropriate resource (e.g., Physician Advisor).
- Resolves discrepancies at the time of review or escalates unresolved issues to the Physician Advisor and departmental leadership.
- Coordinates with the care team to change patient status as needed.
- Notifies the care team when a patient does not meet medical necessity per InterQual, MCG guidelines, or the Two-Midnight Rule and escalates appropriately.
4. Compliance & Performance Standards
- Adheres to all federal, state, payer, and hospital compliance requirements related to utilization management.
- Maintains confidentiality of patient information in accordance with HIPAA.
- Meets productivity standards, including review volume, timeliness, and documentation quality.
5. Hybrid Work Standards and Accountability
- Adheres to the standards outlined in the Nuvance Health Remote Work Program Policy when utilizing a hybrid work arrangement.
Demonstrates regular, reliable and predictable attendance.
Performs other duties as required.
Education Skills Experience
Associate's degree in nursing
3 years experience in acute care or subacute care Nursing
3 years experience as Utilization Management Nurse in an acute care or subacute care setting preferred.
PREFERRED: Bachelor's degree or master's degree in nursing Current NYS RN License.
CCM/ACM Preferred
NYS PRI certification preferred; required within 60 days of hire. MCG Certification Preferred
Working Conditions
Derived Working Conditions
Essential
Significant manual skills / motor coord & finger dexterity
Significant occupational risk
Very Heavy effort. May exert up to 50 lbs. force
Significant exposure to dirt, odor, noise, human waste, etc.
Company: Vassar Brothers Medical Center
Org Unit: 1190
Department: Care Coordination
Exempt: No
Hourly Rate: $48.49-$73.58
