Do you have a passion for caring for older adults? If so you have found the right place to continue your career! Join our compassionate and dedicated team and make a difference in the lives of our members at RiverSpring Health Plans. RiverSpring Health Plans, serves over 18,000 frail and disabled individuals who choose to live in their homes and live independently for as long as possible. The Clinical Utilization Registered Nurse works directly with the Clinical Utilization Director in supporting clinical decisions for hospital and skilled nursing admissions, decisions on Personal Care Aide services for high hour cases, and decisions for high dollar medical equipment.

The Clinical Utilization Registered Nurse is responsible for collaborating with Care Management in order to support the defense of fair hearings, PCA high hour decisions, and MAP admissions.

Current valid New York State license as Registered Professional Nurse. Bachelor's Degree in nursing required. Minimum of two (2) years in managed care setting, Care Management, Utilization Management and/or Grievance and Appeals experience. Demonstrated knowledge of Medicare and Medicaid regulations. Strong analytical skills. Effective oral and written communication skills. Strong organizational skills. Thorough knowledge of personal computer, especially proficiency with Microsoft Word, PowerPoint, and Excel. Ability to work and manage problems independently.

Compensation: $95,000-$110,000 Annually

Our staff are our greatest asset and as such we offer an excellent and comprehensive benefits package which includes:

HEALTH & INSURANCE BENEFITS*

Medical and Prescription Drug
Company-Paid Dental
Company-Paid Vision
Company-Paid Life Insurance and Accidental Death & Dismemberment
Company-Paid Short-Term Disability
Company-Paid Long-Term Disability
Health Care Flexible Spending Account
Dependent Care Flexible Spending Account
Employee Assistance Plan
Additional Life Insurance options for the employee and family members
Additional Disability options
403(b) Plan, with a generous employer contribution

TIME OFF BENEFITS*
Holidays
Personal Days
Sick Days
Vacation

ADDITIONAL BENEFITS*
Bereavement Days
Cell Phone Discount Plan
Commuter Plan
Jury Duty Days
Marriage Days
Pet Insurance Discount Plan
Tuition Assistance
Wellness Programs
Years of Service Awards

*This information is subject to change and it is not meant to be a comprehensive explanation of our employee benefits. The benefits contained in this benefit summary could change at any time without notice.

EOE