Nursing Jobs in Dix Hills, NY
$90,000 - $125,000 / hour
Utilization Review (MDS) – RN/LPN Location: Valley Stream, New York Job Type: Full-Time Schedule: Hybrid (Onsite Required 4 Days per Week) Compensation: $90,000 – $125,000 annually (DOE) About the Role We are seeking an experienced Utilization Review (MDS) RN/LPN to support Skilled Nursing Facility (SNF) operations and ensure accurate clinical review, care coordination, and reimbursement optimization. This position plays a key role in managing utilization review activities, supporting MDS-related processes, and collaborating with interdisciplinary teams to achieve positive clinical and financial outcomes. The ideal candidate will possess a strong background in skilled nursing, utilization review, managed care, and reimbursement processes. Key Responsibilities Utilization Review & MDS Management Conduct utilization review activities for SNF residents to ensure appropriate level of care and reimbursement. Review admissions, continued stays, payer changes, and discharge planning activities. Coordinate prior authorizations, clinical updates, denials, reconsiderations, and appeals with managed care organizations. Monitor reimbursement opportunities and ensure compliance with payer guidelines and regulatory requirements. Collaborate with interdisciplinary teams to support care planning and clinical outcomes. Review and analyze MDS assessments for accuracy, completeness, and reimbursement optimization. Participate in utilization review meetings and daily census management activities. Ensure timely issuance and submission of denial notices, NOMNCs, and related documentation. Maintain detailed and accurate records of all utilization management activities. Qualifications Required Active and unrestricted RN or LPN license . Minimum 3 years of experience in Skilled Nursing Facilities (SNF), utilization review, MDS coordination, managed care, case management, or related healthcare settings. Strong understanding of: MDS processes and reimbursement methodologies Utilization review and utilization management Prior authorizations and payer requirements Denials management and appeals Medicare, Medicaid, and managed care reimbursement Experience working with EMR systems and insurance portals. Excellent organizational, communication, and problem-solving skills. Ability to manage multiple priorities in a fast-paced environment. Preferred RAC-CT, CPC, CPUR, CCM, or related certifications. Experience working within the New York healthcare market. Why Join Us? Competitive salary: $90,000 – $125,000 DOE Hybrid work schedule with strong work-life balance Opportunity to make a direct impact on patient outcomes and reimbursement success Collaborative interdisciplinary team environment Professional growth and advancement opportunities Stable and growing healthcare organization How to Apply If you are an experienced RN or LPN professional with expertise in Utilization Review, MDS, and managed care , we encourage you to apply and become part of a team dedicated to delivering exceptional patient care while ensuring operational excellence. Apply today to advance your healthcare career with a meaningful and impactful role. INDCONF3 $54,095 - $155,538 / year
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Company: Oak Street Health Title: RN, Case Manager Location: Freeport 14-16 Brooklyn Ave, Freeport, NY 11520 Hempstead 210 Fulton Ave, Hempstead, NY 11550 Far Rockaway 10-48 Beach 20th St, Far Rockaway, NY 11691 *Subject to adjustment based on clinic needs *Eligible candidates may receive a sign‑on bonus as part of the offer package. Role Description: In partnership with the primary care provider, (PCP), the RN, Case Manager is the lead for care management activities, drives care coordination and collaborates with interdisciplinary teams to ensure care continuity for complex patients. This role focuses on preventing avoidable admissions, driving efficient resource utilization, and ensuring effective team-based care. It is a field-based, in-person/on-site role, requiring strong relationships between patients, providers and care team members. Core Responsibilities: Manages an assigned caseload of complex patients in a value-based care environment, with a focus on driving reduced admissions, readmissions, and medical utilization. Accountable for panel metric performance in admission prevention, readmission prevention, and transitions of care metrics. Owns overall care coordination for assigned patients, functioning as the primary point of contact and ensuring alignment, accountability, and follow-through across the care team. Manage transitions of care episodes for patients on their panel, including timely completion of structured clinical assessments to identify post-discharge needs, medication reconciliation on behalf of the PCP, and addressal of identified needs directly or via collaboration with other team members. Collaborates patient’s PCP, family/caregiver, Social Worker, Behavioral Health Specialists, and other care team members, as needed to evaluate the individual's needs, goals, and plan of action and ensure care plan progression. Ensure timely documentation of key clinical assessments after admissions, while balancing in-center care team planning meetings. Lead in-person interdisciplinary care planning meetings to ensure effective care coordination and management between providers visits. Perform timely nursing assessments and provide patient education for chronic condition management and transitions of care. Educate patients and families, empowering them in their care, and advocating for their needs. Document visits in electronic health record according to internal standards Other duties as assigned. What are we looking for? Fluency in Spanish or other languages spoken by people in the communities we serve, strongly preferred Current RN license in assigned state is required; Bachelor degree in nursing preferred. Minimum of 6-8 years nursing experience. Certified Case Manager (CCM) required, or willingness to obtain within 12 months of hire, unless candidate has 2-3 years of relevant care/case management experience 2+ years experience in transitional nursing, emergency room nursing, care coordination, discharge planning, or home health is strongly preferred. Demonstrated skill in motivational interviewing, patient activation, time management, and navigating community and social resources. A flexible and positive attitude Comfort with ambiguity and change High emotional intelligence as evidenced by ability to evaluate/perceive a situation from multiple lenses and understand various perspectives in coming to problem resolution. Access to reliable transportation and ability to travel throughout the communities OSH serves US work authorization Someone who embodies being Oaky What does being Oaky look like? Radiating positive energy Assuming good intentions Creating an unmatched patient experience Driving clinical excellence Taking ownership and delivering results Being relentlessly determined Why Oak Street Health? Oak Street Health is on a mission to rebuild healthcare as it should be, providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient communities, and focused on the quality of care over volume of services. We are an organization on the move! With over 200+ locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody Oaky values and passion for our mission. Oak Street Health Benefits: Mission-focused career impacting change and measurably improving health outcomes for Medicare patients Paid vacation, sick time, and investment/retirement 401K match options Health insurance, vision, and dental benefits Opportunities for leadership development and continuing education stipends New centers and flexible work environments Opportunities for high levels of responsibility and rapid advancement Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply. Learn more at www.oakstreethealth.com/diversity-equity-and-inclusion-at-oak-street-health Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,095.00 - $155,538.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan . No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 06/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. 
Hiring Licensed Practical Nurses (LPNs) for Long Term Care Facilities. Immediate Hire!! Hourly pay rate: $34-$45 Make a difference on your own schedule and terms. As one of Five Star’s Licensed Practical Nurses, you will have access to: • Flexible Scheduling! (Days, Evenings, Nights, and Weekends available!) • Paid Orientations • Competitive Weekly Pay with Direct Deposit • Dedicated Office staff & 24-hour On-call Service • Positive Work Environment • Medical, dental, vision, and other insurance options available • Paid Sick Leave • Lucrative Referral Bonuses LPN/Licensed Practical Nurse Requirements: • Currently holds an active LPN License to work in New York • CPR/BLS Certified • Meets all State and Federal requirements for US employment in a Nursing Facility • Ability to communicate effectively • Strong patient assessment skills • Demonstrated clinical competency We look forward to hearing from you soon. Apply today! 
Main Function: Under the supervision of the Clinical Nurse Manager, performs duties in the care and treatment of patients on maintenance dialysis. We are seeking a Registered Nurse who has at least 1 year of experience, caring for patients on dialysis. Candidate must be licensed in CT and have current BCLS certification. Candidate should have knowledge with computers and electronic charting. We offer very competitive compensation and comprehensive benefits. Join us and be part of a dynamic and professional team in a state of the art facility. 
