Utilization Insurance Specialist
3 weeks ago
Join the Mount Sinai Health System team as a Utilization Insurance Specialist, where you will play a critical role in ensuring the efficient and effective management of patient care.
Key Responsibilities:- Conduct concurrent reviews of patient admissions and continued stays to ensure appropriateness and timeliness of services.
- Develop and maintain relationships with clinicians, insurance providers, and other stakeholders to facilitate smooth communication and authorization processes.
- Monitor and coordinate the designation of alternative levels of care with the UM Manager and/or Program Manager and Physician.
- Notifies and coordinates inpatient services when delays are noted in order to reduce length of stay and improve quality of care.
- Responsible for data and report generation of providers as well as regulatory agencies, as needed for Utilization Management activities.
- Masters degree preferred with experience in related field.
- Computer literate: must know MS Word, Excel, Access, and be able to learn work-related applications.
- Highly organized, articulate, with demonstration of sound judgment, mature attitude, excellent interpersonal and communication skills.
- Requires minimal supervision.
The Mount Sinai Health System is committed to delivering exceptional patient care and advancing health for all people, everywhere. We are passionate about creating an inclusive and welcoming work environment where all feel valued, belong, and are able to advance professionally.
We are an equal opportunity employer and do not discriminate on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression.
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