- Cordis (Trenton, NJ)
- …or annual basis. + Focused on driving depth and increasing Cordis product utilization in existing accounts through the cultivation of new physician users and ... to all staff (including Physicians, Mid-Level providers, nurses, techs, and management ). + Complete training and obtain certification Closure products demonstrating… more
- CVS Health (Trenton, NJ)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- US Tech Solutions (Hopewell, NJ)
- …case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and ... to the continuum of care. Performs duties and types of care management as assigned by management .** **Responsibilities:** 1. Assesses patient's clinical… more
- CVS Health (Trenton, NJ)
- …a licensed Registered Nurse , any compact licensure must cover New Jersey** + Utilization Management is a 24/7 operation and the work schedule may include ... Jersey or Compact RN License + 3+ years of clinical experience + Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and… more
- CenterWell (Trenton, NJ)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Hackensack Meridian Health (Edison, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- CVS Health (Trenton, NJ)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Evolent (Trenton, NJ)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- US Tech Solutions (Branchburg, NJ)
- …on an acute/critical care unit, organ donation/transplant unit, in tissue/blood banking, utilization review and/or case management with critical care skillset ... Critical Care + Organ donation transplant unit experience. + Review or case management experience. **Nice to have (but not required) skill** + Associate degree or,… more
- Fresenius Medical Center (Flemington, NJ)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- US Tech Solutions (Branchburg, NJ)
- …on an **acute/critical care** unit, organ donation/transplant unit, in tissue/blood banking, utilization review and/or case management with critical care skill ... set knowledge preferred * CTBS Certified or willing to obtain within two years of employment **Essential Skills, Experience, and Competencies** Understanding & Recognizing (but not limited) the following: * physical assessment findings * history & physical… more
- Hackensack Meridian Health (Edison, NJ)
- …expert computer skills. + Familiar with hospital resources, community resources, and utilization management . + Excellent written and verbal communication skills. ... a leader of positive change. The **Care Coordinator, Care Management ** is a member of the healthcare team and...degree. **Licenses and Certifications Required:** + NJ Licensed Registered Nurse or NJ Licensed Social Worker or NJ Licensed… more
- Intermountain Health (Trenton, NJ)
- …+ Care Management Certification + Demonstrated experience in case management , utilization review, or discharge planning. + Bi-Lingual/Spanish Speaking ... The RN Ambulatory Care Manager I delivers comprehensive ambulatory care management services to identified patients. Leveraging clinical expertise, this role involves… more
- Sharecare (Trenton, NJ)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- AristaCare (Manchester, NJ)
- Unit Nurse Manager (RN) AristaCare is seeking a RN Unit Manager to oversee the care management of a population of patients within an assigned area, unit or ... process, assessment, planning, implementation, and evaluation under the scope of the State's Nurse Practice Act of Registered Nurse licensure. The Unit Manager -… more
- Penn Medicine (Plainsboro, NJ)
- …discharge planning and communicates plan clearly to patient, family and Utilization Review Nurse , Financial Counselor and outpatient treatment providers ... interdisciplinary treatment team in a general hospital setting, providing case management and primary psychotherapy with inpatients and outpatients suffering from… more
- Highmark Health (Trenton, NJ)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Oracle (Trenton, NJ)
- …alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal candidate ... sessions, and offer ongoing consultation to support user proficiency and system utilization . Monitor project outcomes, track key metrics, and report progress to… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …Knowledge, Skills and Abilities Preferred: + Knowledge of evidence-based criteria, utilization review, discharge planning and case management . Licenses and ... patient flow and assure continuity of care. Report pertinent information to management and administration. They provide supervision of staff in the delivery of… more
- Hackensack Meridian Health (Edison, NJ)
- …Skills and Abilities Preferred: 1. Knowledge of milliman and/or interqual criteria, utilization review, discharge planning and case management . Licenses and ... patient flow and assure continuity of care. Report pertinent information to management and administration. He/she provides supervision of staff in the delivery of… more
