Registered Nurse (RN) - Utilization Review in Irvington, NY

Job Description Medical Solutions Direct Hire is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Irvington, New York. Job Description & Requirements - Specialty: Utilization Review - Discipline: RN - Start Date: 02/09/2026 - Duration: Ongoing - 37 hours per week - Shift: 12 hours, days - Employment Type: Staff Job DescriptionRN Care Manager Opportunity – White Plains, NY Direct Hire | Full-Time | Day Shift A leading acute-care healthcare organization in White Plains, NY is seeking an experienced RN Care Manager for a permanent, full-time position. This role offers a predictable weekday schedule with limited weekend rotation and a strong compensation package in a collaborative care management environment. Position Overview · Permanent, direct-hire role · Acute care hospital setting · Case Management / Utilization Review department · Full-time position (37.5 hours per week) · Day shift · Monday–Friday schedule · EPIC electronic medical record system · One position available · ASAP start Shift Details · Monday–Friday, 9:00am–5:00pm · Weekend rotation: one Saturday and Sunday per month · Guaranteed hours: 37.5 per week · No on-call requirements Compensation & Benefits · Salary range: $126,160.32 – $160,090.32 annually · Hourly rate: $64.70 – $82.10 · Full suite of benefits · Retirement plan Key Responsibilities · Perform comprehensive initial assessments upon admission in accordance with Care Management policies · Screen patients using established high-risk indicators to identify discharge planning and support needs · Provide ongoing reassessment throughout the patient’s hospital course · Coordinate multidisciplinary care at both intra-hospital and inter-hospital levels · Lead transitional care planning activities, including: o Patient and caregiver education o Arrangement of post-acute and aftercare services o Commercial payer coordination o High-utilizer patient root cause analysis · Communicate relevant patient information to interdisciplinary healthcare team members · Support departmental goals related to length of stay reduction, readmission prevention, denial reduction, and patient satisfaction · Perform utilization review (UR) activities per department policy, including: o Commercial payer reviews o Admission clinical reviews o Disposition determinations o Retro and self-audits o Medical necessity variance documentation · Collaborate with healthcare professionals to evaluate and ensure safe discharge planning for geriatric patients across inpatient, emergency, and surgical outpatient settings · Maintain accurate documentation in compliance with department requirements · Participate in performance improvement initiatives · Perform additional duties as assigned Requirements · Active New York State Registered Nurse (RN) license (Required) · BSN required (MSN preferred) · PRI Certification (must be obtained within 3 months of hire) · Screen certification strongly preferred · Care Management certification preferred (CMC, CCM, or similar) · Minimum of 3 years of clinical experience in ED, critical care, or medical-surgical nursing preferred · Previous case management experience preferred · Experience with Milliman/InterQual criteria required · Knowledge of healthcare financial, regulatory, and payer systems preferred · Familiarity with state, local, and federal healthcare programs strongly preferred · Strong computer and documentation skills required Why This Opportunity This role is ideal for an experienced RN seeking a non-bedside, care management-focused position with predictable hours, strong compensation, and the opportunity to make a meaningful impact on patient outcomes and system efficiency. Job Type Full-time Benefits · Health insurance · Dental insurance · Vision insurance · Paid time off · Retirement plan Work Location: In person Contact me directly for more information:/nDaniel Trowbridge/nMedical Solutions Direct Hire/ndaniel.trowbridge@medicalsolutions.com/nC/T: 904-694-1205 About Medical Solutions Direct Hire At Medical Solutions, we’re people who care, helping people who care. No matter how you look at it, there’s a whole lot of care going on in our world and that’s just the way we like it. What do we do? Medical Solutions is one of the nation’s largest providers of total workforce solutions in the healthcare industry, connecting nurses and allied health clinicians with hospitals and healthcare systems across the country and around the corner. Through our family of brands, we also serve a segment of clients outside of the healthcare space. And we’re the very best at what we do. You’ll love our culture that’s filled with heart and soul. As a company and employer, we’re sincerely and unabashedly us. We lead as humans first and believe the unique qualities of each team member make us better together. We share a purpose for helping others and the drive to make a difference. And we offer endless opportunities for personal and professional growth, throughout your career. At Medical Solutions, you’ll find a great place to work and a career home. We’ve received Best Places to Work awards, landed top industry awards, and received accolades for the impact we’ve made in business and within our community. But the only way to really get to know us, is to join us. We think you’ll fit right in.