RN - Utilization Review - Syracuse, NY - RNDS

Job Title: RN - Utilization Review
Location: Syracuse, NY
Type: Contract | 14 Weeks
Shift & Schedule: Day Shift | Monday–Friday

Position Overview:
Navitas Healthcare, LLC is seeking RN - Utilization Review for an exciting Travel or Local job in Syracuse, NY.

Responsibilities

• Perform utilization review and utilization management activities to ensure appropriate patient admissions and continued stays
• Apply MCG and InterQual screening criteria to evaluate medical necessity and level of care
• Review and analyze patient records to support appropriate hospital admissions and discharge planning
• Collaborate with healthcare providers, payers, and regulatory agencies to ensure compliance with CMS guidelines and hospital policies
• Communicate effectively with physicians, case management teams, and insurance companies regarding patient status and care decisions
• Ensure proper documentation and compliance with hospital, state, and federal regulations
• Identify and report cases of overutilization or underutilization of healthcare services
• Support care coordination and assist in reducing avoidable hospital readmissions
• Maintain confidentiality and adhere to professional nursing standards

Requirements

• Active New York State RN License required
• Current BLS Certification required
• Minimum 1.5 years of recent acute care hospital experience within the last 2 years required
• Strong understanding of Utilization Review, Utilization Management, or Case Management
• Knowledge of CMS regulations and hospital admission criteria
• Excellent communication and interpersonal skills

Preferred Qualifications

• Experience with MCG or InterQual screening tools preferred
• EPIC EMR experience preferred
• Experience working with insurance payers and regulatory agencies preferred
• Experience in large acute care hospitals or trauma centers preferred

For more details contact at hdavda@navitashealth.com or Call / Text at 516-862-1169.

About Navitas Healthcare, LLC: It is a Joint Commission Certified / WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.