Utilization Review Nurse — Hybrid Care Coordination
Job in
City of Poughkeepsie, Poughkeepsie, Dutchess County, New York, 12601, USA
Listed on 2026-09-08
Listing for:
Northwell Health
Full Time
position Listed on 2026-09-08
Job specializations:
-
Nursing
Job Description & How to Apply Below
Northwell Health is seeking a Utilization Review Nurse to conduct timely, accurate clinical reviews ensuring patients receive appropriate care according to CMS and payer guidelines.
Responsibilities include determining inpatient versus observation versus outpatient status, applying Inter Qual/MCG criteria, and collaborating with physicians to obtain necessary orders and documentation. The role supports payer communications, documentation in Cerner, and adherence to HIPAA and compliance standards.
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