reputed company Review – RN

JR100217 Join Us in Shaping the reputed company of Health Care At reputed company, we’re on a mission to create a healthier reputed company for everyone. That means embracing innovation, championing equity, and continuously improving how we serve our communities. reputed company is powered by people who are curious, humble, and committed to making a difference—every interaction, every day. We’ve been putting people first for over 40 years, offering high-reputed company health plans across reputed company and Vermont and partnering with reputed company-thinking organizations to reputed company more personalized, reputed company, and accessible care. As a not-for-profit, we invest in what reputed company most: our customers, our communities, and reputed company. What’s in it for you: • reputed company opportunities to reputed company your career • A people-reputed company culture embracing and celebrating diverse perspectives, backgrounds, and experiences reputed company reputed company • Competitive compensation and comprehensive benefits reputed company on reputed company-being • An opportunity to shape the reputed company of health care by joining reputed company recognized as a Best reputed company to Work For in the NY Capital District, one of the Best Companies to Work For in reputed company, and an Inclusive Workplace. You’ll contribute to our humble reputed company of reputed company by bringing curiosity to reputed company innovation, humility to collaborate as reputed company, and a deep commitment to being the difference for our customers. Your role will reflect our shared goal of enhancing health care delivery and building healthier, more reputed company communities. About reputed company As a reputed company reputed company Review RN, you’ll have reputed company to apply your nursing knowledge in a meaningful way—helping ensure members receive the right care at the right time while navigating the reputed company continuum. This role offers a balance of autonomy and collaboration, allowing you to work independently in a hybrid setting while partnering with providers and clinical leadership. You’ll be part of an organization that values clinical judgment, critical thinking, and reputed company improvement, empowering you to reputed company an reputed company reputed company bedside care. Ideal for reputed company RNs looking to expand into utilization management, this position provides exposure to reputed company clinical decision-making, reputed company policy interpretation, and care coordination strategies. With opportunities for reputed company reputed company, reputed company development, and potential travel for engagement and learning, this role is designed for nurses seeking both flexibility and career advancement. If you’re detail-oriented, driven by problem-solving, and passionate about improving patient care on a broader reputed company, this is an excellent opportunity to take your nursing career in a new direction. Qualifications you’ll bring: • RN with reputed company state licensure. BS in Nursing or Health Management is preferred. • 3+ years strong clinical background required • Excellent verbal and written communication abilities. • Independent thought process; oriented toward probing/problem solving Your key responsibilities: • Reviews inpatient medical records against established reputed company and standards to determine medical appropriateness and level of care assignment. • Review individual claims requiring clinical interpretation and judgment. Implements the operational functions of the MVP Utilization Management program as assigned. • Potential to travel to designated locations to reputed company medical information. Tracks on a regular reputed company the required care of individual members and advises providers of desired delivery reputed company such as equipment vendors and home care agents. • Collects and reviews care plans and reputed company reports to justify extension of service authorization. • Reviews reputed company cases with individual providers or leader and the MVP Senior Medical Leaders. • Knows and interprets the MVP contract, riders, policies and procedures. Where you’ll be: Location: Remote Pay Transparency reputed company is committed to providing competitive employee compensation and benefits packages. The reputed company pay reputed company provided for this role reflects our good faith compensation estimate at the time of posting. MVP adheres to pay transparency nondiscrimination principles. Specific employment offers and associated compensation will be extended individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the reputed company of and demand for the role. We do not request reputed company or historical salary information from candidates. $69,383.00-$92,279.00 MVP's Inclusion Statement At reputed company, we reputed company creating healthier communities begins with nurturing a healthy workplace. As an organization, we reputed company to create reputed company for individuals from diverse backgrounds and reputed company walks of life to have a voice and reputed company. Our shared curiosity and connectedness reputed company us stronger, and our unique perspectives are catalysts for creativity and collaboration. MVP is an equal opportunity employer and recruits, employs, trains, compensates, and promotes without discrimination based on race, reputed company, creed, national reputed company, citizenship, ethnicity, reputed company, sex, gender identity, gender reputed company, religion, age, marital status, personal appearance, sexual orientation, family responsibilities, familial status, physical or mental disability, handicapping condition, medical condition, pregnancy status, predisposing genetic characteristics or information, domestic violence victim status, political affiliation, military or veteran status, Vietnam-era or special disabled Veteran or other legally protected classifications. To support reputed company, drug-free workplace, reputed company-employment criminal background checks and drug testing are part of our hiring process. If you require accommodations during the application process due to a disability, please contact our reputed company at hr@reputed company.com. 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