- Trinity Health (Philadelphia, PA)
- …**Description:** Nazareth Hospital, a member of Trinity Health Mid-Atlantic, is seeking experienced Utilization Management RN to join the Case Management ... Under the general supervision of the Manager of Utilization Management , the Utilization RN assists physicians and the interdisciplinary team in… more
- Geisinger (Philadelphia, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... Philadelphia area to join Geisinger as an In-House Travel RN ! 12-week assignments are available in Adult Med Surg,...*some specialties may experience a wait list at times Full -time hours Market leading all-inclusive rates Travel allowances for… more
- Fresenius Medical Center (Philadelphia, PA)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Insight Global (Philadelphia, PA)
- …Active RN License or Active LPN License 2-3 years of clinical experience ( Utilization management or utilization review) Strong computer skills Ability to ... of medical records assigned by a Clinical Quality Lead nurse . Miles will be reimbursed for any travel. Computer...diverse and inclusive environments where people can bring their full , authentic selves to work every day. We are… more
- CVS Health (Trenton, NJ)
- …more personal, convenient and affordable. **Position Summary** This is a fulltime remote Utilization Management Nurse Consultant opportunity. Utilization ... external constituents in the coordination and administration of the utilization /benefit management function. + Typical office working...of residence + 3+ years of experience as a Registered Nurse working in ER, Med/Surg, and/or… more
- Humana (Trenton, NJ)
- …and help us put health first** Humana Healthy Horizons in Ohio is seeking a Utilization Management Nurse 2 who utilizes clinical nursing skills to support ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with no… more
- Intermountain Health (Trenton, NJ)
- …REGISTRATION, LICENSE (*indicates primary source verification requirement) Required: + Active Registered Nurse License Preferred: + Certified Healthcare Access ... Associate (CHAA) EXPERIENCE Required: + Licensed Registered Nurse + Minimum of 2 years'...experience in acute clinical nursing setting + Knowledge of utilization management and case management … more
- Penn Medicine (Plainsboro, NJ)
- …graduate level education. . **_Related Work Experience_** + Previous experience working as a Registered Nurse . + Unit Budget We believe that the best care ... Manager within our Telemetry Unit. This role is full time, day shift. Our Telemetry Nurse ...+ Quality Improvement Plan + Unit budget + Resource Utilization + Human Resource Management + Master… more
- Humana (Trenton, NJ)
- …part of our caring community and help us put health first** The Compliance Nurse Auditor reviews utilization management activities and documentation to ... to prevent and detect fraud, waste, and abuse. The RN Compliance Nurse 2, Quality Assurance Audit...care, skilled and/or rehabilitation clinical setting + Experience with utilization management , pre-service denials and/or quality assurance… more
- Guardian Life (Trenton, NJ)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move… more
- Penn Medicine (Philadelphia, PA)
- …overtime utilization + Assists with the implementation of change management strategies within the practice in alignment with department, entity/Penn Medicine ... Penn Medicine Washington Square- 800 Walnut St **Hours:** Per Departmental Needs - Full Time Summary: + The Clinical Coordinator will be responsible for overseeing… more
- CVS Health (Trenton, NJ)
- …state of New Jersey as one of the following: Licensed Clinical Social Worker (LCSW), Registered Nurse ( RN ), Clinical Nurse Specialist (CNS), Licensed ... the plan and works across various departments including Care Management , Utilization Management , Quality ...confidence **Education** Master's degree in behavioral health field; or Registered Nurse (BSN preferred) ers **Pay Range**… more
- Virtua Health (Marlton, NJ)
- …Licensure and/or certification from the State of New Jersey as a MSW or Registered Nurse . Case Management Certification (requirement within one year of ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
- Penn Medicine (Philadelphia, PA)
- …patient care. Nursing Clinical Coordinator also works collaboratively with the Bed Management RN and the Nursing Administrative Coordinator. Responsibilities: + ... With guidance from the Nursing Administrative Coordinator, he/she assumes full responsibility for staffing functions from 1600 - 0700...satisfaction. Credentials: + Basic Cardiac Life Support (Required) + Registered Nurse - PA (Required) + 3… more
- Humana (Trenton, NJ)
- …your skills to make an impact** **Required Qualifications** + Associate degree + Active Registered Nurse , ( RN ), License in your state of residence without ... and/or process improvement experience + Minimum 3 years utilization management experience with exposure to grievance...a good faith estimate of starting base pay for full time (40 hours per week) employment at the… more
- Trinity Health (Philadelphia, PA)
- …or BA in Nursing + PA RN License + Three (3) years of utilization management or case management experience, including emphasis on discharge planning. + ... **Employment Type:** Full time **Shift:** 12 Hour Day Shift **Description:**...a member of Trinity Health Mid-Atlantic, is seeking experienced RN Care Manager to join our ED team! **Schedule:**… more
- Select Medical (Marlton, NJ)
- …time frame + Assuring payments of hospital-based services meeting patient-related utilization management criteria + Implementation of safe and appropriate ... 08053 **Case Manager** - **Inpatient Rehab** **_Shift Hours_** **:** Full Time, 8hr shift **Benefits of becoming a Case...Social Work or in a clinical or related discipline ( RN preferred), per state guidelines for case management… more
- Lilly (Philadelphia, PA)
- …bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to our communities through philanthropy and ... and therapeutic ecosystem (referral dynamics, comprehensive diagnostics, treatments, and care management ) must be further developed for patients to be diagnosed and… more