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Clinical Utilization Manager, RN


Visiting Nurse Service of New York (VNSNY) is the nation’s largest not-for-profit community-based health system. VNSNY provides a comprehensive array of home- and community-based programs, including health plans, tailored to the needs of high-risk, vulnerable New Yorkers, improving their quality of life. Each day,more than 18,000 VNSNY employees — including nurses, rehabilitation therapists, social workers, dieticians, other allied professionals, and paraprofessionals — deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources tomore than35,000 patients, helping them to live the best lives possible.


Oversees and directs clinical utilization/authorization for field staff to ensure effective utilization management as defined by inter professional best practices. Ensures clear and appropriate visit utilization using evidence-based practices to provide positive clinical outcomes and efficient use of resources. Identifies and addresses inter-professional performance issues related to utilization management among staff and provides individualized performance evaluation assessments to clinical leadership and staff. Works under general supervision.

Licensure: License and current registration to practice as a Registered Professional Nurse required.

Certification: Population Care Coordination certification required within one year of job entry date. Care Management, Case Management, OASIS or other applicable certification preferred.

Education: Bachelor&rsquot;s or Master&rsquot;s Degree in Nursing required.

EXPERIENCE: Minimum two years experience as a registered nurse in home care required. Utilization management and/or managed care experience preferred. Proficiency in Microsoft Office applications required. Demonstrated analytical skills required.