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About Christian Health:
We have had the privilege of caring for those in need for more than a century. Founded on the belief that everyone has the right to exceptional care, today we continue to provide quality care and services for our many residents, patients, and clients. Caring is not simply what we do, it is who we are.
Why Join Our Team:
Across our four campuses, eleven communities, five service offerings, and hospital, we are ultimately one unified team. Together, we nurture a compassionate, collaborative culture that enables continuous improvement and allows our team members to learn, grow, and shine in their careers. Surround yourself with people who care about making a difference – come join us!
We have an exciting opportunity for a Utilization Review Nurse to work in Ramapo Ridge Behavioral Health (RRBH). The Utilization Review Nurse promotes effective utilization and monitoring of health care resources to achieve desired clinical, financial and resource outcomes. Verifies all insurance coverage eligibility, benefit details, pre certification/authorization requirements and billing/claims instructions. Ensures accurate insurance data is available in the medical record. Works collaboratively with the interdisciplinary treatment team to review all managed care medical record documentation for compliance as required in a timely manner. Ensures that medical record documentation for patients admitted to RRBH meets medical necessity criteria for each level of care. Provides for timely and accurate clinical reviews as required to ensure compliance with managed care organizations. Follows up and assesses any managed care denials for risk/benefit of appeal. Demonstrates an understanding of, and embraces, the mission statement of the Christian Health.
Schedule: Full-time Monday - Friday 8am – 4pm
Education:
Qualifications:
Christian Health offers a wide variety of benefits to full-time employees that includes Health Insurance, a Dental Program, Paid Vacation and Holidays, 401k, Life Insurance, Tuition Reimbursement, Employee Assistance Program and Direct Deposit.
Full Time
$91k-113k (estimate)
06/27/2024
07/10/2024
christianhealthnj.org
Wyckoff, NJ
100 - 200
Ambulatory Healthcare Services
The following is the career advancement route for Utilization Review Nurse positions, which can be used as a reference in future career path planning. As an Utilization Review Nurse, it can be promoted into senior positions as a Clinical Outcomes Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review Nurse. You can explore the career advancement for an Utilization Review Nurse below and select your interested title to get hiring information.