Northwell Health is seeking a Utilization Review Nurse to conduct timely, accurate clinical reviews ensuring patients receive appropriate care according to CMS and payer guidelines.
Responsibilities include determining inpatient versus observation versus outpatient status, applying InterQual/MCG criteria, and collaborating with physicians to obtain necessary orders and documentation. The role supports payer communications, documentation in Cerner, and adherence to HIPAA and compliance standards.
#J-18808-LjbffrUtilization Review Nurse — Hybrid Care Coordination in city of poughkeepsie at Unknown Company
This position is listed as full time and onsite.