Twelve utilization review nursing jobs are slated for elimination at Montefiore Medical Center in the Bronx, a move the nurses union says is tied to an AI-based reorganization.
Those positions are spread across Montefiore's Moses, Einstein, and Weiler campuses, and the announcement came only months after New York City's largest nurses strike, wherein workplace safeguards were a major issue.
What's happening?
Among the nurses affected is Marilyn Shuler, a registered nurse who has worked at Montefiore for 39 years. She and 11 others received letters May 28 stating their employment would end Sunday, following a 45-day notice period.
The New York State Nurses Association, according to WSWS, says Montefiore started automating utilization review earlier this year and named Datavant as the software vendor.
Montefiore disputed that account, calling it "inaccurate and misleading," but the hospital did not say who would take over the work or clarify its relationship with Datavant.
These nurses handle the paperwork and clinical review needed to get care approved and paid for by insurers. Their work includes examining records, establishing medical necessity, answering insurer questions, and challenging denials.
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Because they are involved in disputes over surgeries, treatments, and hospital stays, utilization review nurses can directly affect whether patients obtain coverage for the care their doctors recommend.
Why does it matter?
Fewer nurses handling complex insurance cases could mean missed details, weaker appeals, and a greater risk of delayed or denied coverage for care doctors have already prescribed.
The layoffs are also drawing scrutiny because they come after the contract that ended this year's strike. NYSNA highlighted artificial intelligence protections in that deal, but union leaders now say those measures did not stop the positions from being targeted.
Montefiore, the flagship of an $8.8 billion health system, posted an operating loss of $120.9 million in 2025 after losing more than $250 million in federal emergency funding, even though money from patient care went up.
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AI's role here ties into a pattern. Training and running AI tools takes major computing power, which drives up electricity and water use at data centers, and utilization review software is no exception. Done well, automation could help nurses handle paperwork faster and free them up for more cases or direct patient care. But when hospitals use it to cut staff, it can mean fewer people checking automated decisions along with the added strain AI puts on local power grids and water supplies.
What's being done?
In response, the union launched a class action grievance and used a July 1 virtual town hall to demand that Montefiore reverse the cuts.
"Artificial intelligence should never replace real human caring from a nurse," NYSNA President Nancy Hagans said, per WSWS, while affected workers pushed for a bigger role in deciding how the technology is used.
Hospitals may view automation as a cost-saving tool, but regulators have said clinical denials should involve medical professionals.
Montefiore's cuts follow a broader trend of companies citing AI as a reason for layoffs, even as researchers say evidence that AI is driving job losses remains limited.
"What we want from Montefiore is simple: Stop the layoffs, keep a licensed nurse on the final review, use AI to support us instead of replacing us, and sit down with the nurses who actually do this work," Shuler said.
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