Job Summary
A non-profit organization has an open position for a Remote New York Licensed Utilization Management MLTC Registered Nurse.
Core Responsibilities Include:
- Verifying that all aspects of the clinical record are in agreement with the member's clinical and functional status
- Conducting comprehensive review of all components related to requests for services
- Actively identifying opportunities for alternative care options and contributes to the development of patient focused plan of care
Qualifications for this position include:
- Minimum two years of utilization review experience with strong cost containment /case management background
- Current license to practice as a Registered Professional Nurse in New York State required
- Knowledge of Medicaid and/or Medicare regulations required
- Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills
- Working knowledge of Microsoft Excel, Power-Point, and Word and strong typing skills required
