- 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
- 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
- Centene Corporation (New York, NY)
- …and determination of coverage for medically necessary health care services. Answers Utilization Management directed telephone calls; managing them in a ... license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for all… more
- Hackensack Meridian Health (Brick, 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...and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title - Nurse Practitioner-Pediatric Cardiology - Mount Sinai Hospital - Full Time - Day** A nurse practitioner (NP) as described in ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Mount Sinai Health System (New York, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title: Clinical Nurse -Wound Care-WOCN-Mount Sinai Hospital-FT/Evenings 4pm-12am** The Nurse Clinician is a registered professional ... skills in an area of clinical nursing specialization. The nurse clinician is able to guide and promote the...Patient/Family education 3) D/C planning and follow-up 4) Case management 5) Research + Maintains clinical expertise in area… more
- Mount Sinai Health System (New York, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Mount Sinai Health System (Long Island City, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Veterans Affairs, Veterans Health Administration (Kings County, NY)
- …orientation, competencies and providing quality improvement and outcomes utilization consultation. Independently provides patient-centered and recovery-oriented care ... health conditions. Facilitate warm hand-offs, telemental health care, and nurse -led psychoeducational groups; use therapeutic communication techniques, practice de-escalation… more
- Centene Corporation (New York, NY)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Nurse Manager is responsible for the management of nursing practice and operations on a designated unit/service. This includes, but is ... not limited to, the management of: clinical nursing practice, staff recruitment, retention, labor...records, internal and external regulatory and survey requirements. The Nurse Manager I collaborates with multiple professionals to support… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Nurse Manager I is responsible for the management of nursing practice and operations on a designated unit/service. This includes, but is ... not limited to, the management of: clinical nursing practice, staff recruitment, retention, labor...records, internal and external regulatory and survey requirements. The Nurse Manager I collaborates with multiple professionals to support… more
- Atlantic Health System (Basking Ridge, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work 8AM- 4PM in the Somerset County area, including ... heavy caseload (up to 4 patients a day); time management skills are essential. However, it is important to...of care for the patient and family Ensures appropriate utilization of services + Maintains visit productivity standards +… more
- Molina Healthcare (New York, NY)
- …post-discharge coordination to reduce hospital readmission rates and emergency room utilization . * Performs face-to-face in-person visits in a variety of settings ... states besides home state based on business need. * Collaborates with fellow nurse practitioners to develop best practices to perform work duties efficiently and… more
- Project Renewal, Inc. (New York, NY)
- …programs + Participates in the development and implementation of quality assurance management and utilization review + Participates in interdisciplinary meetings ... Title: Primary Care Nurse Practitioner - Part Time Program: Healthcare Department...$87,000 depending on experience Position Overview: The Primary Care Nurse Practitioner working in Mobile Health is responsible for… 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
- Elevance Health (Woodbridge, NJ)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- Schedule . 5 days a week 37.5 - 40 hours per week Respiratory Nurse (RN) We are searching for a highly motivated, flexible, organized, skilled respiratory therapist ... meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions. +… more