- 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
- 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
- CVS Health (Bordentown, 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
- 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
- Trinity Health (Philadelphia, PA)
- **Employment Type:** Part time **Shift:** **Description:** ** Registered Nurse ** **Location: LIFE Broad Street, Philadelphia PA** **Status:** On-Call **Shift:** ... holidays **$2,500 sign on bonus and day one benefits** **Position Purpose:** The Registered Nurse (RN) is responsible for providing oversight and management to… more
- AristaCare (Manchester, NJ)
- …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 Registered Nurse license in the state of… more
- Penn Medicine (Philadelphia, PA)
- …daily assignment (Outlook, Canopy, CERME, ECIN, shared drive, Internet) Credentials: + Registered Nurse Licensure - PA (Required) Education or Equivalent ... Working for this leading academic medical center means collaboration with top clinical , technical and business professionals across all disciplines. Today at Penn… more
- Highmark Health (Trenton, NJ)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... 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
- CVS Health (Trenton, NJ)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more