Utilization Review Specialist
2 days ago
The Utilization Review Specialist plays a critical role in ensuring that patients receive the most appropriate and efficient care possible. This position requires a strong understanding of healthcare systems and the ability to collaborate with healthcare teams to coordinate care delivery.
Key Responsibilities- Collaborate with healthcare teams to plan and coordinate patient care
- Identify and address system variations and service delivery barriers that impact patient outcomes
- Perform utilization management activities, including follow-up on denial claims and communication with managed care carriers
- Facilitate assignment of level of care and respond to payer requirements to avoid adverse financial consequences
- Provide superior customer service and model the We Care Standards
- Bachelor's Degree in Nursing
- Three to five years of relevant clinical medical surgical, ICU or ER experience
- HC-PRI certification and PRI screen preferred
- Current NYS RN license required
The ideal candidate will possess effective written and verbal communication skills, decision-making and problem-solving skills, and insurance carrier comprehensive assessment skills. They must be detail-oriented and comfortable with investigating outcomes and communicating with physicians, physician extenders, and managed care systems over the phone and online.
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Registered Nurse
3 weeks ago
Nyack, New York, United States Nyack Hospital Full timeJob SummaryWe are seeking a highly skilled Registered Nurse to join our team at Nyack Hospital. As a critical care specialist, you will be responsible for providing high-quality patient care in our PACU department.Key ResponsibilitiesManage and coordinate patient care through effective communication with patients, families, and the healthcare team.Utilize...
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Senior Finance Specialist
1 month ago
Nyack, New York, United States The Ladders Full timeJob Overview As a Senior Finance Specialist, you will play a pivotal role in overseeing monthly management and quarterly financial reporting for our organization. This includes consolidating reports for our parent company and ensuring accuracy at the entity level. Key ResponsibilitiesManage corporate tax calculations and estimated tax payments for the entire...
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Life Insurance Specialist
3 weeks ago
Nyack, New York, United States Eric Jaslow - State Farm Agent Full timeJob OpportunityEric Jaslow - State Farm Agent is seeking a qualified and empathetic professional for the role of Life Insurance Specialist.Job SummaryThis is a customer-oriented position that requires marketing the best Life insurance services and products to benefit clients and their families.Key ResponsibilitiesEstablish Customer Relationships: Develop and...
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Automotive Service Specialist
1 month ago
Nyack, New York, United States Audi Nyack Full timeJoin our dynamic team as an Automotive Service Specialist! At Audi Nyack, we are committed to fostering your professional development and success. Our well-established service center is equipped with cutting-edge tools and technology specifically designed for Audi vehicles. We pride ourselves on providing a supportive environment that encourages growth and...
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MRI Imaging Specialist
1 month ago
Nyack, New York, United States Nyack Hospital Full timeAt Nyack Hospital, we are dedicated to providing exceptional healthcare services with a focus on community well-being. Our commitment to quality care mirrors that of a leading academic medical institution while fostering a supportive environment for our staff. Our Benefits Include:Retirement savings plan with matching contributionsComprehensive medical,...
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Contract Specialist
2 weeks ago
West Nyack, New York, United States The Salvation Army Eastern Territory Full time{"title": "Contract Specialist", "content": "Job SummaryThe Salvation Army Eastern Territory is seeking a highly skilled Contract Specialist to join our team. As a Contract Specialist, you will be responsible for reviewing and analyzing legal documents to ensure compliance with regulatory requirements and The Salvation Army's mission, program guidelines, and...
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MRI Imaging Specialist
1 month ago
Nyack, New York, United States Nyack Hospital Full timeAt Nyack Hospital, we are dedicated to providing exceptional healthcare services while ensuring the well-being of our community and our employees. Our Benefits Include:Retirement savings plan with matching contributionsComprehensive medical, dental, and vision coverageTuition assistance for professional developmentGenerous Paid Time Off, including 8...
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OCI Architect
2 days ago
Nyack, New York, United States LTIMindtree Full timeAbout UsLTIMindtree is a global technology consulting and digital solutions company that enables enterprises across industries to reimagine business models, accelerate innovation, and maximize growth by harnessing digital technologies. As a digital transformation partner to more than 700+ clients, LTIMindtree brings extensive domain and technology expertise...
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Sales Engagement Specialist
1 month ago
West Nyack, New York, United States Pepper Full timePosition OverviewAbout Us:Pepper is an innovative enterprise focused on revolutionizing the mobile payment landscape. Our unique strategy and collaborations with leading national retailers empower users to earn rewards with every transaction, enhancing the overall value of their everyday purchases. Central to our mission is a dedication to a consumer-centric...
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Orthopedic Care Coordinator
4 weeks ago
Nyack, New York, United States Nyack Hospital Full timeAbout the RoleWe are seeking a highly skilled Care Management Specialist - Orthopedic Care Coordinator to join our team at Nyack Hospital. As a key member of our care coordination team, you will play a vital role in ensuring the seamless transition of care for our patients.Key ResponsibilitiesUtilize the nursing process to provide optimal quality and...
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Structural Design Specialist
2 weeks ago
Nyack, New York, United States CSG Full timeStructural Engineer Role at CSG **Job Summary** CSG is seeking a skilled Structural Engineer to join our team. As a Structural Engineer, you will be responsible for preparing formal calculation reports for design confirmation submissions to clients. **Key Responsibilities** * Prepare calculation packages for submission to clients * Draft structural...
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Otolaryngology Specialist
4 weeks ago
West Nyack, New York, United States MedChi, The Maryland State Medical Society Full timePosition Overview:MedChi, The Maryland State Medical Society, is in search of a dedicated E.N.T. Specialist/Otolaryngologist to enhance our healthcare offerings. We are committed to transforming healthcare delivery while ensuring a supportive environment for our clinicians.Why Choose MedChi?At MedChi, we prioritize a clinician-led approach that emphasizes...
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Physician - Internal Medicine Specialist
5 hours ago
West Nyack, New York, United States UnitedHealth Group Full timePhysician - Internal Medicine Specialist OpportunityCare for patients with a range of medical conditions, from chronic diseases to acute illnesses, in a collaborative environment that prioritizes quality over quantity.Key Responsibilities:Direct and manage a complete continuum of high-quality care within the care teamTreat chronic diseases and...
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Healthcare Quality Specialist
1 month ago
Nyack, New York, United States Tandym Group Full timePosition Overview:A prominent health services organization is seeking a dedicated professional to join their team as a Quality Coordinator. This role is essential in ensuring the enhancement of medical record documentation across both inpatient and outpatient settings.Key Responsibilities:The Quality Coordinator will be tasked with:1. Promoting the...
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Senior Patient Service Representative
2 weeks ago
Nyack, New York, United States WMC Health Network Full timeJob SummaryThe Senior Patient Service Representative provides on-site leadership for daily operations in a medical secretary setting. As a liaison between practitioners and patients, this role coordinates the delivery of care and services. Key responsibilities include assisting patients with check-in and check-out processes, educating patients on post-care...
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Psychiatric Registered Nurse
2 weeks ago
Nyack, New York, United States Nyack Hospital Full timeAbout the RoleWe are seeking a highly skilled and compassionate Registered Nurse to join our team in the Psychiatric Emergency Department at Nyack Hospital. As a key member of our multidisciplinary healthcare team, you will be responsible for providing high-quality patient care and contributing to a positive and supportive work...
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Radiologic Technologist
6 days ago
West Nyack, New York, United States Optum Full timeDiagnostic Imaging SpecialistOptum is seeking a skilled Diagnostic Imaging Specialist to join our team in the Tri-State region. As a Diagnostic Imaging Specialist, you will play a critical role in providing high-quality diagnostic imaging services to our patients.Key Responsibilities:Perform diagnostic imaging procedures, including X-rays, to diagnose or...
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Healthcare Radiologic Technologist
1 week ago
West Nyack, New York, United States Optum Full timeDiagnostic Imaging SpecialistOptum is seeking a skilled Diagnostic Imaging Specialist to join our team in the Tri-State region. As a Diagnostic Imaging Specialist, you will play a critical role in providing high-quality diagnostic imaging services to our patients.Key Responsibilities:Perform diagnostic imaging procedures, including X-rays, to help diagnose...
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Radiologic Technologist
5 days ago
West Nyack, New York, United States Optum Full timeDiagnostic Imaging SpecialistOptum is seeking a skilled Diagnostic Imaging Specialist to join our team in the Tri-State region. As a Diagnostic Imaging Specialist, you will play a critical role in providing high-quality diagnostic imaging services to our patients.Key Responsibilities:Perform diagnostic imaging procedures, including X-rays, to diagnose or...
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Healthcare Radiologic Technologist
1 week ago
West Nyack, New York, United States Optum Full timeDiagnostic Imaging SpecialistAt Optum, we're committed to helping people live healthier lives and making the health system work better for everyone.We're seeking a skilled Diagnostic Imaging Specialist to join our team in the Tri-State region. As a Diagnostic Imaging Specialist, you'll play a critical role in delivering high-quality patient care and...