- Cognizant (Trenton, NJ)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Trenton, NJ)
- …both verbal and written **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules...will include weekends, holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to… more
- US Tech Solutions (Hopewell, NJ)
- …**Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the ... care management as assigned by management.** **Responsibilities:** 1. Assesses patient's clinical need against established guidelines and/or standards to ensure that… more
- Fresenius Medical Center (Flemington, NJ)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- St. Luke's University Health Network (Sellersville, PA)
- …regardless of a patient's ability to pay for health care. This Weekend registered Nurse works collaboratively with other members of the interdisciplinary team ... standards for the provision of quality care, appropriate service utilization , and compliance with third party payor requirements for...school of professional nursing who is licensed as a Registered Nurse by the state in which… more
- ChenMed (Philadelphia, PA)
- …We're rapidly expanding and we need great people to join our team. The Registered Nurse , Care Line, is responsible for providing telephonic triage directional ... on-call coverage, the incumbent in this role provides remote clinical advice and assessments within license and as possible...license and as possible given technology and medium. The registered nurse collaborates with primary caregivers and… more
- St. Luke's University Health Network (Bethlehem, PA)
- …graduate of an approved school of professional nursing who is licensed as a Registered Nurse by the state in which practicing, Baccalaureate degree preferred. ... to agency standards for the provision of quality care, appropriate service utilization , and compliance with third party payor requirements for reimbursement. 7.… more
- St. Luke's University Health Network (Easton, PA)
- …we serve, regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the ... populations across the continuum of care. Also works with the providers, registered nurse care managers, social workers, and multi-disciplinary care teams… more
- St. Luke's University Health Network (Phillipsburg, NJ)
- …low frequencies and to touch as related to telephone and computer keyboard. EDUCATION: Registered Nurse with current license to practice in the State of ... The RN Care Manager coordinates the overall progression of care, resource utilization , and discharge planning for designated patient populations across the continuum… more
- CVS Health (Lambertville, NJ)
- …hires upon achieving proficiency in the role. **Required Qualifications** + Active, unrestricted ** Registered Nurse (RN) license in New Jersey** . + Minimum of ... high-quality, cost-effective care for our members. These strategies encompass utilization management, quality improvement, network coordination, and clinical … more
- Penn Medicine (Philadelphia, PA)
- …our future each day. Are you living your life's work? Summary: + The Clinical Nurse Educator (CNE) practices within the UPHS professional practice model and ... nurse evaluates and integrates best current evidence with clinical expertise and patient/family preferences and values for the...resources and set priorities for maximizing outcomes. Credentials: + Registered Nurse - PA (Required) + Basic… more
- Evolent (Trenton, NJ)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- BAYADA Home Health Care (Blue Bell, PA)
- …continuum of care in Senior Living **_._** Are you a solutions-oriented, team-focused ** Registered Nurse , Licensed Practical Nurse or Therapist (Physical ... members to deliver on our differentiated offerings. Through the utilization of outcome driven data analytics, this role will...professional growth. **Qualifications:** + Current PA licensure as a Registered Nurse , Licensed Practical Nurse ,… more
- AristaCare (Philadelphia, PA)
- …process, assessment, planning, implementation, and evaluation under the scope of the State's Nurse Practice Act of Registered Nurse licensure. The Unit ... Manager - RN coordinates resource utilization , timely and appropriate care interventions, and interdisciplinary communication...and regulatory compliance. Requirements; + Must possess, a valid LPN/ Registered Nurse license in the state of… more
- Deloitte (Philadelphia, PA)
- …certification a plus (CRC, CCA, CCS-P, CCS, CPC, CDIP, CCM) + Experience as clinical registered nurse , physician, physician assistant, case manager, ... or physician assistant required + Current Registered Nurse (RN) license required + Certified Clinical ...clinical documentation specialist, utilization review, informatics RN, Quality, DRG Validation and health… more
- Penn Medicine (Philadelphia, PA)
- …on needs of the unit, this individual may also serve in the capacity as a clinical nurse in the operating room. Follows fiscal and Human Resources policies in ... (Required) + BLS/CPR, as a healthcare provider as per the American Heart Association. + Registered Nurse - PA (Required) + Pennsylvania RN licensure + 2-5 years… more
- Stryker (Philadelphia, PA)
- …related discipline required + Minimum 4 years of experience as a licensed clinician, preferably registered nurse in critical care + Must be able to track and ... As a Clinical Specialist you will deliver pre-sale and post-sale...internal and external education on process, tool optimization, and utilization in collaboration with internal stakeholders + Uncover relevant… more
- Penn Medicine (Philadelphia, PA)
- …health system organization **Credentials:** + Basic Cardiac Life Support (Required) + Registered Nurse - PA (Required) **Education or Equivalent Experience:** + ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- Penn Medicine (Philadelphia, PA)
- …into daily assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse - PA (Required) + PA RN Licensure required. ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- ChenMed (Philadelphia, PA)
- …bachelor's degree in a related clinical field preferred + A valid, active Registered Nurse (RN) license in State of employment required + Compact License ... through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care...Supports, collaborates and partners with the Complex Care and Clinical Strategy Teams on the day-to-day execution of our… more