Clinical Underwriting Specialist

1 week ago


Schenectady, New York, United States MVP Health Care Full time
Clinical Expertise in Medical Underwriting

MVP Health Care is committed to delivering high-quality healthcare solutions. We are seeking a skilled Clinical Underwriting Specialist to join our team. As a Clinical Underwriting Specialist, you will play a vital role in evaluating medical risks and making informed underwriting decisions.

About the Role
This position involves analyzing medical and pharmacy utilization reports to predict future claim costs. You will collaborate with healthcare providers and insurance teams to gather additional medical information as needed. Your expertise in medical terminology, conditions, treatments, and outcomes will be invaluable in making informed underwriting decisions.

Responsibilities
* Analyze medical and pharmacy utilization reports to assist underwriting in predicting future claim costs
* Collaborate with healthcare providers and insurance teams to gather additional medical information as needed
* Evaluate risks and opportunities in new business and renewal groups, and assess patient clinical needs against established guidelines
* Use knowledge of medical terminology, conditions, treatments, and outcomes to assist in making informed underwriting decisions
* Make recommendations based on analysis and review; providing clinical, medical review, and expertise for cost of care
* Work with the Care Management team to ensure claimants are engaged in care management protocols

What's in it for you?
* Competitive compensation package
* Comprehensive benefits focused on well-being
* Opportunities for growth and professional development
* A dynamic and collaborative work environment

Requirements
* Active Registered Nurse (RN) license
* Bachelor's degree in Nursing, Health Administration, or a related field preferred
* Minimum of 4 - 6+ years of professional relevant work experience, requires a minimum of two (2) years of clinical experience
* Knowledge of ICD 10 coding and medical terminology
* Strong understanding of medical conditions, treatments, and their long-term impact on health and insurability
* Ability to analyze complex medical information and make informed decisions
* Excellent communication and collaboration skills

Salary Information
The estimated salary range for this role is $69,383.00 - $83,000.00 per year, depending on location and experience.

Join Our Team
MVP Health Care is an equal opportunity employer and welcomes applicants from diverse backgrounds. We are committed to creating a healthy and inclusive work environment where everyone can thrive.

  • Schenectady, New York, United States Mvp Health Plan Inc Full time

    Company OverviewMVP Health Care is a mission-driven organization committed to creating a healthier future for everyone. We strive for innovative thinking and continuous improvement in the healthcare industry.Salary Range$69,383 - $83,000 per year, depending on qualifications and experience.About the RoleWe are seeking a skilled Clinical Underwriting Nurse...


  • Schenectady, New York, United States Mvp Health Plan Inc Full time

    Medical Underwriting Nurse Role at MVP Health Care:We're seeking a Medical Underwriting Nurse to join our team, where you'll play a crucial role in shaping the future of healthcare. This position offers a unique blend of clinical expertise and analytical skills, enabling you to make informed decisions that impact patient outcomes.Key Responsibilities:*...


  • Schenectady, New York, United States Diedre Moire Corp. Full time

    **Overview of the Role:**Diedre Moire Corporation is seeking an experienced Senior Environmental Insurance Specialist to join our team. This individual will play a key role in underwriting and marketing environmental insurance products, conducting risk assessments, and financial analysis to determine credit quality.**Key Responsibilities:**Underwrite and...


  • Schenectady, New York, United States Diedre Moire Corp. Full time

    We are seeking an experienced Environmental Risk Management Specialist to join our team at Diedre Moire Corporation in Schenectady, NY. As a key member of our underwriting team, you will play a critical role in evaluating and managing environmental risks for our clients.Job Summary:The Environmental Risk Management Specialist will be responsible for...


  • Schenectady, New York, United States Marshall + Sterling Inc Full time

    Job OverviewWe are seeking an experienced Client Service Specialist to join our P+C Upstate Division at Marshall + Sterling Inc. This role offers the opportunity to provide exceptional service to clients and support the growth objectives of our agency.About the RoleThe successful candidate will be responsible for providing excellent service to clients by...


  • Schenectady, New York, United States Trinity Health Full time

    St. Peters Health Partners Medical Associates, P.C. is seeking a dedicated Clinical Pulmonary Specialist to join our team in a dynamic outpatient setting located in the Capital District of New York.Job Summary:We are looking for a highly skilled Clinical Pulmonary Specialist to provide comprehensive care for pulmonary and sleep patients in an office-based...


  • Schenectady, New York, United States Allied Digestive Health Full time

    Job Title: Clinical Infusion Nurse SpecialistWe are seeking a skilled and compassionate Clinical Infusion Nurse Specialist to join our team at Allied Digestive Health in Albany, New York.About UsAt Allied Digestive Health, we are a dynamic physician-led organization with a strong commitment to providing exceptional patient care. Our team of board-certified...


  • Schenectady, New York, United States Marshall & Sterling Full time

    Company Overview: At Marshall & Sterling, we strive to provide exceptional customer service and expert knowledge in the insurance industry. Our team is dedicated to helping clients achieve their goals and mitigate risk.Job Summary: We are seeking an experienced Insurance Account Specialist to join our team. As an Insurance Account Specialist, you will be...


  • Schenectady, New York, United States MARSHALL & STERLING INC Full time

    Job OverviewWe are seeking a skilled Claims Client Service Specialist to join our team at Marshalls & Sterlings INC. As a key member of our P+C Upstate Division, you will play a vital role in providing exceptional service to our clients and supporting the growth objectives of our agency.This is an exciting opportunity for a dedicated professional to grow...


  • Schenectady, New York, United States The Fortus Group, Inc. Full time

    We are seeking a dedicated Clinical Healthcare Specialist for an immediate opening at The Fortus Group, Inc. in Schenectady, NY.The estimated salary for this position is approximately $120,000 per year, based on national averages and industry standards for Registered Nurses in the United States.Job Description:Fulfill clinical responsibilities as part of a...


  • Schenectady, New York, United States Matrix Medical Network Full time

    Job OverviewWe are seeking a skilled Clinical Healthcare Specialist to join our team in Schenectady, New York.This is a PRN/Part Time opportunity that offers flexible scheduling and the chance to make a direct impact on the health and well-being of others.ResponsibilitiesConduct comprehensive assessments of adult and geriatric patients in their homes or...


  • Schenectady, New York, United States Allied Digestive Health Full time

    Job SummaryWe are seeking a highly skilled Gastroenterology Nurse Specialist to join our team at Allied Digestive Health in Albany, New York.About the RoleThe successful candidate will be responsible for conducting thorough nursing interviews to determine medical eligibility for screening colonoscopy/endoscopy procedures. This involves collecting and...


  • Schenectady, New York, United States Allied Digestive Health Full time

    We are seeking a highly skilled Licensed Practical Nurse Direct Access to join our team at Allied Digestive Health, a leading gastroenterology care network with over 200 providers and 60 locations throughout New Jersey and New York.Job SummaryThe Licensed Practical Nurse Direct Access will be responsible for conducting nursing interviews, managing patient...


  • Schenectady, New York, United States Allied Digestive Health Full time

    We are seeking a highly skilled Gastroenterology Specialist to join our team at Allied Digestive Health in Albany, NY. The ideal candidate will have experience in hospitalist or strong primary care settings.About the RoleAs a Gastroenterology Specialist, you will be responsible for managing patients' health issues in both outpatient and inpatient settings....


  • Schenectady, New York, United States Allied Digestive Health Full time

    Job Summary:The Registered Nurse Infusion role at Albany Gastroenterology Consultants involves administering infusion therapies to patients in an outpatient setting.About the Role:Administer treatments and monitor patients for drug reactionsCoordinate care with other medical entitiesThis position requires a minimum of three years of clinical experience in...


  • Schenectady, New York, United States Allied Digestive Health Full time

    We are seeking a skilled Registered Nurse Infusion to join our team at Allied Digestive Health, one of the largest integrated networks of gastroenterology care centers in the nation.Job SummaryThe Registered Nurse Infusion will be responsible for operating an infusion clinic to administer outpatient infusion therapies and monitor patient results. This role...


  • Schenectady, New York, United States Integrity Locums Full time

    We are seeking an experienced Critical Care Specialist to join our team at a leading healthcare facility.About the OpportunityThis is a unique opportunity to work in a dynamic environment with a high volume of patients. The ideal candidate will have excellent clinical skills, strong communication abilities, and the ability to work independently.**Clinical...


  • Schenectady, New York, United States Albany Medical Center Full time

    Job OverviewAlbany Medical Center is seeking a highly skilled Emergency Nurse Specialist to join our team in the Infectious Disease Med/Surg Unit. This role requires excellent clinical judgment and leadership skills to provide high-quality patient care.


  • Schenectady, New York, United States Tandym Group Full time

    Seeking a Medical Oncology Specialist for an outpatient opportunity at our practice in Schenectady, NY. The role offers a competitive compensation package and comprehensive benefits. Our medical oncology team provides cutting-edge cancer care with a range of services, including diagnosis, treatment, support, survivorship, and palliative care, as well as...


  • Schenectady, New York, United States Springboard Healthcare Full time

    Springboard Healthcare is seeking a skilled Travel Imaging Specialist for a travel job in New York. The successful candidate will have the opportunity to work as an Allied Health Professional, utilizing their expertise in CT Technology to make a positive impact.Job DescriptionA 13-week contract with a reputable healthcare organization awaits. This full-time...