Utilization Review Specialist
St. Vincent's Hospital Westchester•Town/Village of Harrison, NY
•$55,000 - $60,000
About The Position
The Utilization Review Specialist serves as the liaison between the hospital’s inpatient and ambulatory services and managed care organizations. The role includes obtaining authorization for all levels of care, conducting medical necessity reviews, monitoring patient benefits, and maintaining knowledge of SJMC contractual agreements. The specialist works closely with hospital departments, including inpatient and outpatient treatment teams, Evaluation and Referral, Benefits, and Patient Accounts.
Requirements
- One year of experience in a healthcare and/or managed care setting.
- Undergraduate or bachelor’s degree required.
Nice To Haves
- A degree in Human or Health Services is preferred.
Responsibilities
- Obtain authorization for all levels of care.
- Conduct medical necessity reviews.
- Monitor patient benefits.
- Maintain knowledge of SJMC contractual agreements.
- Coordinate with inpatient and outpatient treatment teams, Evaluation and Referral, Benefits, and Patient Accounts.
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What This Job Offers
Job Type
Full-time
