Previous Job
RN Utilization Manager
Ref No.: 16-03255
Location: New York, New York
Title: Utilization Manager
Location: Brooklyn
Duration: Contract to hire or direct hire

Manages the utilization management and assessment audit teams to ensure that standards for service delivery and team/staff performance levels are met or exceeded. This includes supporting the VNSNY CHOICE teams on a day- to-day basis for utilization issues, problem resolution, complaint resolution and other service related issues. Manages and coordinates the activities of the VNSNY CHOICE teams by ensuring that appropriate and high quality services are provided and are consistent with Agency mission, principles, policies and regulatory compliance. Works under general supervision.

Licensure: License and current registration to practice as a registered professional nurse in New York State required.
Valid driver's license or NYS Non-Driver photo ID card, may be required as determined by operational/regional needs.

Education: Bachelor’s Degree or equivalent work experience in management for a health plan or utilization/case management required. Master’s Degree in Nursing or Health Care Administration preferred. Case Management Certification preferred.

Experience: Minimum of four years’ experience in home care, care management or related field, including three years of progressive experience in case or utilization Management, required. Effective oral/written communication and interpersonal skills preferred strong MLTC knowledge.