Utilization Review Rn Jobs in Syracuse, NY (NOW HIRING)

Duties Description Registered Nurse 2 (Medical Care) positions at NYSIF are responsible for coordinating global case management of high-cost complex cases and are an extensive resource for the NYS Workers' Compensation Board Medical Treatment Guidelines for Claims Service Managers and other Claims staff.
Responsibilities include, but are not limited to:
• Claimant Outreach.
• Catastrophic claims management.
• Calculating and processing RX bills.
• Arranging non-emergency transportation.
• Reviewing prior authorization requests for surgeries.
• DME and other treatments.
• Post-audit of DRG/EAPG bills.
• Facilitating claimant discharges from facilities.
• Setting up and negotiating home care services.
Minimum Qualifications For appointment via NY HELPS:
• Possession of a license and current registration as a registered professional nurse in New York State; and one year of post-licensure clinical nursing experience in the following areas: rehabilitation, medical/surgical, public health, community health, visiting nursing, occupational health, utilization review, or review of medical records from hospitals for appropriate ICD 9 or 10/DRG/PAS/CPT coding.
For competitive appointment:
• Transfer: Current New York State employee with one year of permanent competitive class service in a title eligible for transfer under Section 70.1 of Civil Service Law. Appointments via transfer must not result in a second, consecutive transfer with an advancement of more than two S-grades or one M-grade. Eligible titles include, but are not limited to: Registered Nurse 1, Registered Nurse 1 (Health Services), Registered Nurse 1 (Spanish Language).
• Reinstatement: Candidates who have held a Registered Nurse 2 (Medical Care) title, or a transferable title, may be eligible for consideration for reinstatement.
Preferred Qualifications:
• Experience with case management and CCM
Please be advised that the New York State Insurance Fund (NYSIF) does not offer sponsorship for employment visas to employees or potential employees. Candidates sponsored for employment by an organization should be aware of their sponsorship status and the relevant expiration date(s) of that sponsorship before applying to this position. NYSIF is not currently enrolled in eVerify, which is a requirement for certain types of employment verifications.
Additional Comments Please note, the salary range displayed includes special salary treatments, such as location pay.
Fringe Benefits:
• Competitive compensation
• Future career growth potential
• Open and supportive team-based environment
• Plentiful vacation, personal, and sick time off
• Paid state and federal holidays
• Affordable health insurance plans
• Dental and vision benefits provided at no additional cost
• Retirement options
• Public Student Loan Forgiveness (PSLF)
• Possibility of telecommuting, flextime, and Alternative Work Schedules (AWS)
NY HELPS Program:
This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS).
For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, which means no examination is required but all candidates must meet the minimum qualifications of the title for which they apply.
At a future date, it is expected employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, without having to compete in an examination. Employees will then be afforded with all the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified.
About NYSIF:
For more information about NYSIF, including our mission, commitment to diversity, equity, and inclusion, and efforts to fulfill Executive Order 31, please visit www.nysif.com.
If you are a person with a disability and wish to request that a reasonable accommodation be provided for you to participate in a job interview, please send an email to NYSIF's Reasonable Accommodations mailbox at ra@nysif.com.
Some positions may require additional credentials or a background check to verify your identity.
Name Meg Corcoran
Telephone
Fax 518-437-1618
Email Address hr@nysif.com
Address
Street PO Box 66699
City Albany
State NY
Zip Code 12206
Notes on Applying Please submit resume and cover letter to hr@nysif.com, referencing the Vacancy ID number in your subject line.