New York Licensed Sub-Acute RN Reviewer

Job Summary

To enhance healthcare delivery, the full-time remote New York Licensed Sub-Acute RN Reviewer will conduct clinical reviews for Medicare cases, ensuring compliance with guidelines and supporting optimal patient outcomes.

Key responsibilities:

• Conduct timely and accurate utilization reviews for sub-acute Medicare cases
• Evaluate medical necessity and appropriateness of services based on established criteria
• Collaborate with providers and interdisciplinary teams to ensure optimal patient care

Required qualifications:

• Current and unrestricted NY RN licensure
• Associate or bachelor's degree in nursing (BSN preferred)
• Minimum 3 years of clinical nursing experience
• At least 2 years of experience in utilization management of sub-acute Medicare reviews
• Strong knowledge of sub-acute care and rehabilitation services