Utilization Review Nurse

Pride Health; New York (NY); On-site; USD 89,544 - 103,320; Full time

Benefits offered by this job

Comprehensive healthcare coverage

401(k) retirement savings

Life & disability insurance

Employee assistance program

Legal support

Employee discounts

Job summary

A healthcare organization is seeking an experienced Registered Nurse (RN) – Case Management for their New York location. The RN will be responsible for coordinating patient care, managing resources, and ensuring high-quality patient outcomes. Key responsibilities include performing case management and collaborating with interdisciplinary healthcare teams. Candidates must hold a valid New York RN license and have a minimum of 2 years of experience in case management. This role offers competitive pay and comprehensive benefits.

Qualifications

• Minimum 2 years of experience in Case Management / Resource Management / Utilization Management.

Responsibilities

• Perform case management and resource management for assigned patients.
• Coordinate interdisciplinary care planning and discharge planning.
• Conduct utilization review to ensure appropriate level of care and services.
• Collaborate with healthcare teams to optimize patient outcomes.
• Monitor patient progress and adjust care plans as necessary.
• Ensure compliance with hospital policies and documentation standards.

Skills

Strong clinical assessment

Decision-making skills

Excellent communication

Interdisciplinary coordination

Education

Active New York State Registered Nurse (RN) License

AHA BLS (Basic Life Support) Certification

AHA ACLS (Advanced Cardiovascular Life Support) Certification

Job description

Job Title: Registered Nurse (RN) – Case Management

Location: New York, NY 10037

Start Date: April 19, 2026

Duration: 3 Months (Possible Extension Based on Performance)

Schedule

• Shift: 9:00 AM – 5:30 PM
• Days Per Week: 5

Pay Rate

• Local RN: $65 per hour
• Traveler RN: $75 per hour
• Estimated Weekly Pay: $3,004

Position Overview

We are seeking an experienced Registered Nurse (RN) – Case Management to join our healthcare team in New York. The RN Case Manager will coordinate patient care, manage resources, and ensure appropriate utilization of healthcare services while maintaining high-quality patient outcomes.

Key Responsibilities

• Perform case management and resource management for assigned patients.
• Coordinate interdisciplinary care planning and discharge planning.
• Conduct utilization review to ensure appropriate level of care and services.
• Collaborate with physicians, social workers, and healthcare teams to optimize patient outcomes.
• Monitor patient progress and adjust care plans as necessary.
• Ensure compliance with hospital policies, regulatory requirements, and documentation standards.

Required Qualifications

• Active New York State Registered Nurse (RN) License
• AHA BLS (Basic Life Support) Certification
• AHA ACLS (Advanced Cardiovascular Life Support) Certification
• Minimum 2 years of experience in Case Management / Resource Management / Utilization Management

Preferred Skills

• Strong clinical assessment and decision-making skills
• Excellent communication and interdisciplinary coordination
• Experience with discharge planning and patient advocacy

  Benefits

  Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k) retirement savings, life & disability insurance, an employee assistance program, legal support, auto and home insurance, pet insurance, and employee discounts with preferred vendors.