Twelve utilization review nurses at Montefiore Medical Center's Bronx campuses lose their jobs today — 45 days after receiving elimination letters — as management automates their work through health-data firm Datavant. NYSNA's February contract, celebrated as the first AI safeguard language in the system's history, required only notification and good-faith talks, not management agreement to halt cuts.

Twelve utilization review nurses at Montefiore Medical Center officially lose their positions today, July 12 — 45 days after management sent elimination letters dated May 28 — as the Bronx health system moves their work to a platform operated by Datavant, a health-data company formed through a $7 billion private-equity-backed merger, according to reporting by the World Socialist Web Site.

The nurses are spread across Montefiore's Moses, Einstein and Weiler campuses and are represented by the New York State Nurses Association. NYSNA identified Datavant as the AI vendor and says Montefiore began automating the utilization review process earlier this year. Montefiore called NYSNA's account "inaccurate and misleading" in a statement, but declined to identify who will perform the work going forward or to describe its relationship with Datavant.

Utilization review nurses examine medical records, assemble clinical justifications for care, and fight insurer denials of treatments and extended stays. The role sits at the intersection of patient access and hospital revenue: when a denial goes unchallenged, the patient can lose the care or absorb a bill, and the hospital loses reimbursement.

One of the 12, registered nurse Marilyn Shuler, has worked at Montefiore for 39 years. At a July 1 virtual town hall she said: "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."

NYSNA filed a class-action grievance on June 1 and is demanding Montefiore halt the 45-day clock while the two sides discuss alternatives. But the contract the union signed with Montefiore on February 9 — the agreement that ended the nurses' portion of the largest nurse strike in New York City history, which drew 15,000 NYSNA members beginning January 12 — does not give NYSNA veto power over the cuts.

The contract's AI language, which NYSNA publicly described as a historic first, requires Montefiore to notify the union before implementing technology that affects nursing practice, and to "meet and discuss in good faith" if AI causes a "diminishment" in represented employees. It does not require management to reach agreement with the union or halt a reduction in force. A nurse's right to reject an AI recommendation that conflicts with clinical judgment is protected; the nurse's position is not.

Montefiore is the flagship of an $8.8 billion health system that reported a $120.9 million operating loss in 2025, even as net patient-service revenue climbed from $7.8 billion to $8.2 billion — a gap driven in part by a more than $250 million drop in federal emergency funding. The system has not said publicly how many nurses will remain on the utilization review function after the Datavant automation expands.

The WSWS report also noted that Datavant's subsidiary Ciox Health agreed in May to a $900,000 settlement of a class-action lawsuit over a 2024 data breach involving patient health and financial information.

NYSNA has not announced what it will do if Montefiore rejects its grievance.