- 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
- Mount Sinai Health System (New York, NY)
- …4pm-12am** The Nurse Clinician is a registered professional nurse who demonstrates expert clinical expertise through advanced knowledge and skills ... role. Licensing and Certification Requirements: CWOCN Issued by WOCNB License: Registered Nurse (current registration) Issuing Agency: DOH/Office of Professions… more
- CVS Health (East Windsor, 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
- Hackensack Meridian Health (Edison, NJ)
- … utilization management. **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support HCP ... and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for… more
- Centene Corporation (New York, NY)
- …+ LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse - State Licensure preferred Pay Range: $26.50 - $47.59 per hour Centene ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… 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
- Mount Sinai Health System (New York, NY)
- …Additional Detail** + Licensure: New York State License with current registration as a registered nurse . + State Certification: Certified by the New York State ... earned a separate certification as an NP through advanced clinical nursing education in a distinct specialty area of...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
- Mount Sinai Health System (New York, NY)
- …Additional Detail** 1. Licensure: New York State License with current registration as a registered nurse . 2. State Certification: Certified by the New York State ... earned a separate certification as an NP through advanced clinical nursing education in a distinct specialty area of...follows: a. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
- Mount Sinai Health System (New York, NY)
- …REQUIREMENTS** 1. Licensure: New York State License with current registration as a registered nurse . 2. State Certification: Certified by the New York State ... earned a separate certification as an NP through advanced clinical nursing education in a distinct specialty area of...follows: 3. Is a graduate of New York State registered Nurse Practitioner Program or equivalent OR… more
- Mount Sinai Health System (New York, NY)
- …field. **Licensing and Certification Requirements (if applicable)** Licensed as a registered nurse , Issuing Agency: Department of Health/Office of Professions ... **Job Description** The Nurse Manager is responsible for the management of...includes, but is not limited to, the management of: clinical nursing practice, staff recruitment, retention, labor relations, supply… more
- Mount Sinai Health System (New York, NY)
- …field. **Licensing and Certification Requirements (if applicable)** Licensed as a registered nurse , Issuing Agency: Department of Health/Office of Professions ... **Job Description** The Nurse Manager I is responsible for the management...includes, but is not limited to, the management of: clinical nursing practice, staff recruitment, retention, labor relations, supply… more
- Molina Healthcare (New York, NY)
- …and electronic medical record (EMR) experience. Preferred Qualifications * Experience as a registered nurse or nurse practitioner in a home health, ... primary care and medical care services to members - primarily in non- clinical settings where members feel most comfortable, including in-home, community and nursing… more
- Mount Sinai Health System (New York, NY)
- …The Clinical Program Manager, Clinical Command Center is a Registered Professional Nurse , Physician Assistant, or Nurse Practitioner, who manages ... and supporting patient-centered care. **Qualifications** Must be a Licensed Registered Nurse , Physician Assistant or Nurse...the New York State Department of Education as a Nurse Practitioner 1. Five (5) years of clinical… more
- Hackensack Meridian Health (Edison, NJ)
- …systems; Google Docs, EPIC. **Licenses and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support HCP ... program and its Quality Metrics. + Knowledge of health care delivery system, utilization and review and case review procedures. + Knowledge of Social Determinants of… more
- Deloitte (New York, NY)
- …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
- Mount Sinai Health System (New York, NY)
- …ensure safety, and prevention of falls and injury as directed by the patient's registered nurse . 12. Sets priorities, problem solves and uses proper judgment in ... involving, but not limited to, patient monitoring for safety and clinical needs, providing support and assistance with hospital-based telemedicine services, and… more