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Part Time Utilization Review Manager Jobs in New York

CareOne

MDS Specialist RN

Whippany, NJ · On-site

$83K - $120K/yr

Utilization Review & Triple-Check Coordination: Lead the weekly Utilization Review (UR) and Triple ... We are proud to Offer the following benefits to Part-time (22.5+ hours/week) and Full-time ...

CareOne

MDS Specialist RN

Whippany, NJ · On-site

$83K - $120K/yr

Utilization Review & Triple-Check Coordination: Lead the weekly Utilization Review (UR) and Triple ... We are proud to Offer the following benefits to Part-time (22.5+ hours/week) and Full-time ...

CareOne

MDS Specialist RN

Morristown, NJ · On-site

$83K - $120K/yr

Utilization Review & Triple-Check Coordination: Lead the weekly Utilization Review (UR) and Triple ... We are proud to Offer the following benefits to Part-time (22.5+ hours/week) and Full-time ...

CareOne

MDS Specialist RN

Whippany, NJ · On-site

$83K - $120K/yr

Utilization Review & Triple-Check Coordination: Lead the weekly Utilization Review (UR) and Triple ... We are proud to Offer the following benefits to Part-time (22.5+ hours/week) and Full-time ...

Centerbrite

BCBA (Part-time)

Newark, NJ · On-site +1

$90 - $110/hr

Carry and manage a client caseload , serving as the clinical standard-bearer for the organization ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

Centerbrite

BCBA (Part-time) (Remote)

Newark, NJ · Remote

$90 - $110/hr

Carry and manage a client caseload , serving as the clinical standard-bearer for the organization ... Own documentation quality , utilization reviews, and oversight of treatment plans * Supervise RBTs ...

Encompass Health

Case Manager

Tinton Falls, NJ · On-site

$21.25 - $27.25/hr

Affordable medical, dental, and vision plans for both full-time and part-time employees and their ... Participate in utilization review process: data collection, trend review, and resolution actions.

St. Joseph's Health

Physician Advisor

Paterson, NJ

Benefits Eligibility : (Full-time and Part-time Employees-over 20 hours a week) * Competitive ... Experience with utilization management, denials, medical necessity reviews, or quality improvement ...

St. Joseph's Health

Physician Advisor

Paterson, NJ · On-site

Experience with utilization management, denials, medical necessity reviews, or quality improvement ... Benefits Eligibility : (Full-time and Part-time Employees-over 20 hours a week) * Competitive ...

The Hire Source

Psychiatrist

Stamford, CT · On-site

$200K - $300K/yr

Participate in case discussions and utilization reviews as appropriate * Maintain timely, accurate ... part-time opportunities * 401(k) with employer contribution * Flexible scheduling * Clinical ...

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Showing results 21-40

All JobsUtilization Review JobsPart Time Utilization Review Manager JobsPart Time Utilization Review Manager Jobs in New York

Part Time Utilization Review Manager information

What is the difference between Part Time Utilization Review Manager vs Utilization Review Nurse?

AspectPart Time Utilization Review ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license and management experienceRegistered Nurse (RN) license required
Work EnvironmentOversees review teams, manages processes, and collaborates with healthcare providersConducts patient chart reviews, assesses medical necessity, and communicates with providers
Industry UsageCommonly employed in healthcare organizations, insurance companies, and third-party review firmsPrimarily found in hospitals, insurance companies, and healthcare facilities

While both roles involve reviewing medical cases for insurance or healthcare purposes, the Part Time Utilization Review Manager focuses on overseeing review processes and managing teams, whereas the Utilization Review Nurse directly assesses patient cases and medical necessity. Understanding these differences helps clarify career paths and employer expectations in healthcare review roles.

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Infographic showing various Part Time Utilization Review Manager job openings in New York as of June 2026, with employment types broken down into 85% Full Time, 4% Part Time, 4% Temporary, and 7% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution.

MDS Specialist RN

CareOne

Whippany, NJ • On-site

$83K - $120K/yr

Full-time, Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

CareOne rating

6.8

Company rating: 6.8 out of 10

Based on 30 frontline employees who took The Breakroom Quiz

49th of 242 rated social care providers

Job description


Balance Life & Work with a New Career Opportunity
Now Hiring - Lead MDS/Clinical Reimbursement Coordinator - Whippany, NJ
CareOne at Hanover
Salary Range $83,000 to $120,000 (Full-time)
Lead MDS/Clinical Reimbursement Coordinator will be responsible for, but not limited to:
  • MDS/RAI Process Leadership: Direct the timely and accurate completion of the Minimum Data Set (MDS) and Care Area Assessments (CAAs) in strict compliance with CMS regulations.
  • PDPM & Reimbursement Strategy: Strategically schedule ARDs and audit clinical documentation to capture true resident acuity, optimizing PDPM components, nursing tiers, and NTA scores.
  • Quality Measure & Five-Star Optimization: Analyze Casper reports and partner with the DON/IDT to monitor clinical triggers, drive root-cause corrections, and safeguard the facility's Five-Star rating.
  • Interdisciplinary Care Planning: Oversee the development of individualized resident Care Plans that support MDS coding, establish clear goals, and satisfy all regulatory requirements.
  • Utilization Review & Triple-Check Coordination: Lead the weekly Utilization Review (UR) and Triple-Check meetings, collaborating with therapy, nursing, and the business office to validate medical necessity, track managed care authorizations, and ensure accurate billing alignment prior to transmission.
  • Audit Readiness & Compliance: Systematically audit clinical records (MARs/TARs/physician orders) to defend data integrity against ADRs, MAC/RAC audits, and pre-payment reviews.
  • IDT Collaboration & Care Meetings: Facilitate interdisciplinary meetings to ensure seamless care integration and reimbursement alignment.

Position Requirements:
  • Licensure: Current, unrestricted Registered Nurse (RN) license in the state of practice.
  • MDS Experience: 1-3 years of dedicated MDS experience preferred; or an experienced LTC RN with strong clinical and analytical skills who can be trained.
  • Regulatory Expertise: Thorough knowledge of CMS RAI guidelines, Medicare PPS/OBRA scheduling, and federal/state long-term care regulations.
  • Clinical Knowledge: Strong understanding of general, rehabilitative, and restorative nursing practices, including comprehensive care planning.
  • Software Proficiency: Skilled in Microsoft Windows applications; experience with PointClickCare (PCC) and NetHealth is highly preferred.
  • Operational Skills: Exceptional attention to detail with a proven ability to complete assessments accurately and within strict regulatory deadlines.
  • Autonomy & Flexibility: Ability to work independently and adjust scheduling to support crucial month-end financial close procedures.

About Us
The CareOne mission is to define excellence within the health care community. We are dedicated to Maximizing Patient Outcomes. We treat Residents, their families and each other with respect, dignity and compassion. Through a collaborative and consultative approach, we strive to provide a framework of strength and stability for our Centers and Communities. We work to maintain the highest standards of care and service for Residents, families and our valued employees.
We are proud to Offer the following benefits to Part-time (22.5+ hours/week) and Full-time Employees:
  • Comprehensive Healthcare Benefits
    • Multiple Medical Plans
      • Including Pharmacy
      • Including Teladoc
    • Multiple Dental Plans
    • Vision Plan
    • Health Savings Account (eligibility restrictions apply)
    • Flexible Spending Accounts
    • Voluntary Life and AD&D
    • Short-Term and Long-Term Disability Plans
    • Hospital Indemnity Insurance
    • Critical Illness Insurance
    • Accident Insurance
    • Whole Life Insurance
    • Medicare Employee Assistance
  • Legal Plan
  • Commuter Benefits
  • 401k Retirement Plan
  • Employee Assistance Program (available to all employees)
  • Paid Time Off
    • Vacation
    • Sick Plans in accordance with state laws
  • Opportunities to advance and grow your career

If working with people who are dedicated, compassionate, and concerned about their patients is essential to you, then you'll appreciate being a part of our team. We've built a strong reputation on the outstanding level of care that we provide. We have a graciously appointed facility with strong belief in patient care and service; join us at our beautiful facility!
We are an Equal Opportunity Employer
EEO/AA/M/F/DV

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About CareOne

Sourced by ZipRecruiter

CareOne is a leading healthcare corporation specializing in senior care, rehabilitation, and assisted living services. Based in Fort Lee, New Jersey, CareOne was established to meet the healthcare requirements of seniors across the state and has expanded its footprint over the years. With its dedication to excellence, CareOne provides a comprehensive range of medical and healthcare services, including post-acute care, long-term and assisted living, memory care, respite care, and more.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Fort Lee, NJ, US

Year founded

1999

Social media

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