RN-Case Manager/Utilization Review/CDI

Job Description

Join Our Team as an RN-Case Manager/Utilization Review/CDI and Make a Difference in Patient Care

Are you a dedicated nursing professional seeking a dynamic role that combines clinical expertise with care coordination? Our organization is looking for a skilled RN-Case Manager/Utilization Review/CDI to ensure optimal patient outcomes through effective case management, utilization review, and clinical documentation improvement. This pivotal position offers the opportunity to work in a supportive environment that values your skills and commitment to excellence.

Key Responsibilities:

• Conduct comprehensive utilization reviews to ensure appropriate healthcare services
• Collaborate with multidisciplinary teams to develop and implement patient care plans
• Improve clinical documentation to support accurate coding and reimbursement
• Advocate for patients' needs, ensuring quality and safety standards are met
• Maintain thorough documentation and compliance with healthcare regulations

Required Skills:

• Current New York State RN license
• Certification in Basic Life Support (BLS) with ability to recertify
• Minimum of 1.5 years recent experience within the past 2 years in an acute care hospital setting
• Experience with hospital Electronic Medical Records, preferably EPIC
• Strong interpersonal and communication skills
• Ability to analyze clinical data and documentation critically
• Must have never had professional license or certification suspended, investigated, or been named as a defendant in a liability claim
• Legal right to work in the U.S.
• Successfully pass pre-employment health clearance, drug screening, and criminal background check

Nice to Have Skills:

• Pediatric nursing experience
• Additional certifications in case management or utilization review
• Prior experience in trauma centers or large hospital systems

Preferred Education and Experience:

• Registered Nurse with significant inpatient acute care experience
• Previous experience with hospital-based CDI programs or utilization review teams

Other Requirements:

• Availability to work days with shift length of 8 hours
• Compensation rate of $65.97 per hour
• Willingness to undergo ongoing training and recertification as needed
• Must travel if necessary and be open to relocation based on assignment

This is an excellent opportunity for compassionate, detail-oriented nursing professionals eager to elevate patient care while advancing their careers. If you meet the qualifications and are ready to contribute to a high-performing team, we encourage you to apply now.

VHS is an Equal Opportunity Employer ("EEO")/Protected Veterans/Individuals with Disabilities/E-Verify Employer and welcomes all to apply #LiveYourLife #VHSNY