Utilization Management Specialist

OverviewAt MJHS, we are dedicated to providing exceptional healthcare services to our patients and members. Our team of professionals works collaboratively to ensure that our health plans meet the needs of our diverse population.In this role as a Managed Care Nurse - Utilization Review Specialist, you will play a critical part in reviewing cases and...

At the New York State Office of Mental Health, we are seeking a skilled Healthcare Utilization Specialist to join our team.Job OverviewThe selected candidate will work with us to analyze and evaluate quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness. This role is responsible for...

Cynet Health is seeking a highly skilled Care Manager to join their team in the Emergency Department (ED) for a 9-month contract. This role requires strong leadership experience, excellent clinical expertise, and proficiency in utilization review and care coordination.Key Responsibilities:The successful candidate will be responsible for performing...

Job Summary:SUNY Downstate Health Sciences University's Department of Care Management is seeking an experienced Utilization Review Nurse Specialist to support the review and management of patient care services.Key Responsibilities:* Complete and send initial clinical reviews within 48 hours of admission to payors via Care Management Module, CarePort.*...

Job OverviewMEDNATIONAL is seeking an experienced Utilization Management (UM) Nurse to join our team. This role involves assessing healthcare services to ensure optimal patient outcomes and compliance with regulatory standards.Key Responsibilities:Service Assessment and Compliance: Evaluate healthcare services to guarantee optimal patient outcomes and...

At Stone Management, we are seeking an experienced Asset Risk Management Specialist to join our team. This role is responsible for the credit risk assessment of new and existing transactions presented by the asset securitization team.The successful candidate will provide ongoing deal team support for existing transactions, including ongoing funding and...

Job OverviewMJHS is a leading healthcare organization dedicated to providing high-quality care and services to our patients and members. As a Healthcare Utilization Review Specialist, you will play a critical role in ensuring that our health plan members receive the necessary services and support to maintain their independence and quality of life.

We're offering an exciting opportunity for a talented Utilization Management Nurse to join our team at Metropolitan Jewish Health System. As a Utilization Management Nurse, you'll be responsible for reviewing and processing requests for services to ensure they align with established guidelines and regulations.Key ResponsibilitiesProcess all requests for...

We are seeking a skilled Pest Management Specialist to join our team at Colony Pest Management. In this role, you will be responsible for delivering pest management and consulting services to customers on an assigned route.Job SummaryManage an assigned pest control routePromptly update the PestPac Mobile platform after each service performedWork in a...

About the RoleWe are seeking a highly skilled Gas System Operator - Utility Maintenance Specialist to join our team at Consolidated Edison Inc.Job SummaryThe successful candidate will assist the lead Gas System Operator in maintaining the integrity of the gas transmission and distribution system, ensuring safe, reliable, and economic operations. This...

Utility Commodities Sales SpecialistCore & Main Overview:As a leading distributor of water, sewer, storm drain, and fire protection products in the United States, Core & Main combines local expertise with a national supply chain to provide innovative solutions for new construction and aging infrastructure.About Us:We are committed to the safe distribution of...

Job Description:We are seeking a skilled Salesforce Administrator to join our team at RIT Solutions, Inc. as a Salesforce Configuration Specialist for Energy and Utility Operations. This role will be responsible for designing, developing, testing, and implementing key functional enhancements based on business requirements from our product owner and...

**About M&R Hotel Management**M&R Hotel Management is a dynamic and fast-paced hospitality company dedicated to delivering exceptional customer experiences. **Job Title: Hotel Sales Support Specialist** **Estimated Salary: $55,000 - $65,000 per year** **Job Description:**We are seeking a highly motivated and organized Hotel Sales Support Specialist to join...

Job Title: Commercial Agreement SpecialistAbout Addition ManagementWe are a boutique brand partnership agency based in New York, NY, seeking a highly skilled Commercial Agreement Specialist to join our team. In this role, you will be responsible for managing day-to-day commercial agreement activities, including drafting, revising, and presenting project...

At DirectShifts, we are committed to providing exceptional patient care in the field of pain management. As a highly skilled and compassionate Pain Medicine Specialist, you will play a critical role in our team's efforts to deliver comprehensive pain management services to patients in New York.Job OverviewThis is a dynamic opportunity for an experienced Pain...

The MJHS team is committed to providing high-quality healthcare services to our patients and members.Salary: $85,000 - $110,000 per yearAbout UsAt MJHS, we believe that everyone deserves access to affordable and quality healthcare. Our Medicare and Medicaid managed care health plans are designed to help keep people independent and living life on their own...

Job DescriptionAccenture is a leading global professional services company that helps the world's leading businesses, governments, and other organizations build their digital core, optimize their operations, accelerate revenue growth, and enhance citizen services by creating tangible value at speed and scale.We are a talent- and innovation-led company with...

Job Description:We are seeking a highly skilled and organized Project Management Specialist to join our team at Crosscheck Inspection Services. In this role, you will be responsible for managing multiple projects simultaneously, ensuring timely completion, and maintaining excellent communication with clients and stakeholders.About the Role:This is a...

Asian Community Care Management, Inc. is seeking a skilled Care Coordination Specialist to join our team in New York City. As a Care Coordination Specialist, you will play a critical role in providing high-quality coordination care services to seniors through telephonic assessments and member-centered care planning.About UsAsian Community Care Management,...

Job OverviewWe are seeking a detail-oriented and organized professional to join our team as a Housing Operations Specialist in Queens, Brooklyn, and The Bronx.This role is responsible for managing the day-to-day operations of our employee housing complex, ensuring all documentation is accurate and compliant with current regulatory requirements. Excellent...