Manager of Utilization Management

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POST DATE 9/13/2016
END DATE 1/25/2017

Visiting Nurse Service Of New York Brooklyn, NY

Brooklyn, NY
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Bachelors Degree



Created in 1998, VNSNY CHOICE is the managed care affiliate of the Visiting Nurse Service of New York and shares its mission of compassion and care for the poor, the chronically ill and elderly. Our guiding principle is to help the most vulnerable among us live safely and independently for as long as possible in their own homes and communities. VNSNY CHOICE has 700 employees, including 227 care management staff. On any given day, VNSNY CHOICE coordinates care for more than 40,000 members through its array of Medicare and Medicaid health plans, including Medicaid Long Term Care, Medicare Advantage, and a HIV/Special Needs Plan. With offices in Manhattan, Brooklyn and upstate New York, VNSNY CHOICE health plans are available in the New York City metropolitan area as well as on a plan basis in selected counties throughout New York State.


Manages the utilization management and assessment audit teams to ensure that standards for service delivery and team/staff performance levels are met or exceeded. This includes supporting the VNSNY CHOICE teams on a day- to-day basis for utilization issues, problem resolution, complaint resolution and other service related issues. Manages and coordinates the activities of the VNSNY CHOICE teams by ensuring that appropriate and high quality services are provided and are consistent with Agency mission, principles, policies and regulatory compliance.

Licensure: License and current registration to practice as a registered professional nurse in New York State required.

Education: Bachelor&rsquot;s Degree or equivalent work experience in management for a health plan or utilization/case management required. Master&rsquot;s Degree in Nursing or Health Care Administration preferred. Case Management Certification preferred.

Experience: Minimum of four years experience in home care, care management or related field, including three years of progressive experience in case or utilization Management, required. Effective oral/written communication and interpersonal skills preferred.

VNSNY is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, national origin, disability or protected veteran status. If you would like more information about your EEO rights, then please visit: