- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …utilization of resources and benefits on a case by case basis. Applies case management and utilization review principles in monitoring the delivery of ... to the treatment team, Director of Utilization Management , and the Medical Director. + Review ...Degree **Licenses and Certifications Preferred:** + NJ State Professional Registered Nurse License or NJ Licensed Social… more
- RWJBarnabas Health (Livingston, NJ)
- Case Manager Registered Nurse - Case Management (FT/Days)Req #:0000179789 Category:Nursing Status:Full-Time Shift:Day Facility:Cooperman Barnabas Medical ... Road, Livingston, NJ 07039 Job Summary: The Case Manager Registered Nurse will coordinate discharge planning to...on other classifications of patients as designated by the Utilization /Case Management Review Plan. Coordinates… more
- RWJBarnabas Health (Livingston, NJ)
- Director ( Registered Nurse ), Case Management (Full-Time/Days)Req #:0000180556 Category:Leadership Status:Full-Time Shift:Day Facility:Cooperman Barnabas ... Department, including but not limited to clinical resource management , utilization review , discharge planning,...+ Current and valid license to practice as a Registered Nurse in the state of New… more
- NJM Insurance (Trenton, NJ)
- …years of prior experience in clinical nursing (Med-Surg or Critical Care preferred), Utilization Management Review /Hospital concurrent reviews, and/or Case ... comply with all statutory, regulatory, licensing requirements, and NJM policies/guidelines that affect utilization review and medical management work. + Stay… more
- VNS Health (Manhattan, NY)
- …and updates through on-going training, coaching and educational materials. + For Utilization Management Only: + Issues Determinations, Notices of Action, and ... by state or federal regulations are saved in the Utilization Management System. + Reviews, evaluates and...and Certifications: + Current license to practice as a Registered Professional Nurse or an Occupational Therapist… more
- RWJBarnabas Health (Newark, NJ)
- Registered Nurse ( RN ) Director of Patient Care Cardiac Cath Lab FT DaysReq #:0000180082 Category:Leadership Status:Full-Time Shift:Day Facility:Newark Beth ... the American Heart Association (AHA) + Active New Jersey Registered Nurse License or Multistate Compact License...in advance for potential conflicts or issues. Patient Care Management : Monitors the quality of service and utilization… more
- Hackensack Meridian Health (Neptune, NJ)
- …and serve as a leader of positive change. The **Clinical Documentation Specialist Registered Nurse ( RN )** facilitates improvement in the overall quality, ... inpatient admissions and observations as specified by the facility's Utilization Management / Review Committee for documentation...day in the life of a **Clinical Documentation Specialist Registered Nurse ( RN )** at **Hackensack… more
- Fresenius Medical Center (Princeton, NJ)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Zufall Health Center (Somerville, NJ)
- …living with HIV/AIDS. In the model for MCM Nurse , the role is provided by a registered nurse ( RN ) and will focus on the clinical services of primary care ... Registered Nurse Case Manager Somerville, NJ...with program funding policies. The level of medical case management needed by the individual clients is determined by… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work Monday - Friday from 8 AM to 4 PM in the ... responsible for managing a heavy caseload (up to 4 patients a day); time management skills are essential. However, it is important to provide each patient with the… more
- Northwell Health (Staten Island, NY)
- **Req Number** 144355 Registered Nurse Case Manager - FlexStaff Serves as liaison between the patient and facility/physician. Ensures a continuum of quality ... + Facilitates patient management throughout hospitalization + Performs concurrent utilization management using evidence based medical necessity criteria +… more
- Highmark Health (Trenton, NJ)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Trenton, NJ)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a...facility's Employee Handbook and as communicated by the facility's management . . Contributing to a positive work team by… more
- Highmark Health (Trenton, NJ)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Hackensack Meridian Health (Neptune, NJ)
- …releases accounts as appropriate. + Verifies admission and discharge date information. + Updates Utilization Review RN needed for payors. + Enters all ... necessary information, inclusive of free text fields, to support the case management , utilization review process. + Retrieves information for the Physician… more
- Hackensack Meridian Health (Neptune, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
- Hackensack Meridian Health (Holmdel, NJ)
- …transform healthcare and serve as a leader of positive change. The **Care Coordinator, Utilization Management ** is a member of the healthcare team and is ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to.... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
- RWJBarnabas Health (Long Branch, NJ)
- … License + 3 to 5 years acute care RN experience + Case Management experience Preferred: + Utilization Review or Discharge Planning Experience + Case ... Job Overview: RWJBarnabas Health is seeking a highly dedicated RN to work full time in Case Management... RN to work full time in Case Management for Monmouth Medical Center. Monmouth Medical Center (MMC)… more