Job Description
Hybrid Utilization Review Nurse
Location: Uniondale, Long Island, Nassau County
Schedule: Monday to Friday, 8:30 AM - 5:30 PM
Join our team as a Utilization Review Nurse in a hybrid role that offers a mix of in-office and remote work. Based in Uniondale, Long Island, this position ensures the appropriate use of medical resources while delivering high-quality care management.
Conduct reviews to ensure proper utilization of medical services.
Evaluate patient records for service necessity and appropriateness.
Collaborate with healthcare providers to optimize outcomes.
Analyze clinical data to assess medical necessity.
Recommend actions using evidence-based guidelines.
Communicate with insurers to secure coverage and authorizations.
Maintain detailed documentation to meet compliance standards.
Participate in case management and care coordination meetings.
Active RN license in New York State.
At least 2 years of experience in utilization review.
Strong knowledge of medical terminology and healthcare services.
Excellent communication and interpersonal skills.
Self-starter with effective time management skills.
Proficiency with EHR systems and utilization management tools.
Detail-oriented with analytical and problem-solving expertise.
Competitive salary
Comprehensive health benefits
Retirement plan
Flexible work environment
Professional development opportunities
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Company DescriptionAt HumanEdge Allied Health our mission is simple—connect great healthcare professionals with the best clients in the Healthcare industry. Our process complies with JCAHO standards to ensure the highest quality outcomes on each and every assignment or search we do. When working with our Allied health professionals, you will find the most knowledgeable folks in the business. Whether you’re a healthcare professional seeking a new assignment or full time employment or a healthcare institution needing assistance in staffing your organization, we are here to provide you with the world class service that you deserve.
At HumanEdge Allied Health our mission is simple—connect great healthcare professionals with the best clients in the Healthcare industry. Our process complies with JCAHO standards to ensure the highest quality outcomes on each and every assignment or search we do. When working with our Allied health professionals, you will find the most knowledgeable folks in the business. Whether you’re a healthcare professional seeking a new assignment or full time employment or a healthcare institution needing assistance in staffing your organization, we are here to provide you with the world class service that you deserve.
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