• Utilization Review

    Prime Healthcare (Passaic, NJ)
    …skills. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/189060/ utilization - review - coordinator ... both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able...standards set forth by the Hospital/ Department at UR Coordinator position for at least 6 months.4. 1+ year… more
    Prime Healthcare (01/09/25)
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  • Utilization Review

    Prime Healthcare (Boonton Township, NJ)
    …#LI-TS1 Connect With Us! (https://careers-primehealthcare.icims.com/jobs/185117/ utilization - review - coordinator ... outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service… more
    Prime Healthcare (12/18/24)
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  • Care Coordinator , Utilization

    Hackensack Meridian Health (Neptune, NJ)
    …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... a leader of positive change. The **Care Management, Care Coordinator , Utilization Management** is a member of...as required by payer agencies and initiates physician advisor's review as necessary for unwarranted admissions. + Performs chart… more
    Hackensack Meridian Health (11/15/24)
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  • Care Coordinator , Utilization

    Hackensack Meridian Health (Holmdel, NJ)
    …at Hackensack Meridian _Health_ includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... serve as a leader of positive change. The **Care Coordinator , Utilization Management** is a member of...as required by payer agencies and initiates physician advisor's review as necessary for unwarranted admissions. + Performs chart… more
    Hackensack Meridian Health (11/14/24)
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  • PCMH Nursing Coordinator

    Zufall Health Center (Dover, NJ)
    PCMH Nursing Coordinator Dover, NJ, USA Req #10986 Friday, November 1, 2024 Welcome to Zufall Health! Position Summary The PCMH Nursing Coordinator works in ... high quality care. Patients under the care of the Coordinator will be supported by the development of a...requiring transition of care from hospital to home, high utilization of services, complex medical needs or those at… more
    Zufall Health Center (11/01/24)
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  • Case Coordinator - No Weekends!

    Sevita (Delran, NJ)
    …services for infants, children, adolescents, Military Service Members and Veterans. **Case Coordinator ** Do you enjoy working in a medical/rehab setting and have a ... where you can actively make a difference in people's lives? As Case Coordinator , you will be responsible for providing organizational assistance and program support,… more
    Sevita (01/08/25)
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  • RN Case Manager (Patient Care Coordinator )

    RWJBarnabas Health (Hamilton, NJ)
    …literate, working knowledge of Microsoft applications ex. Word ,Excel Preferred: + Utilization review and discharge planning experience + Case Management ... RN Case Manager (Patient Care Coordinator ) - Hamilton, NJReq #:0000157940 Category:Nurse Case Manager Status:Per Diem Shift:Day Facility:RWJ Hamilton Department:Case… more
    RWJBarnabas Health (01/06/25)
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  • Care Coordinator , Care Management

    Hackensack Meridian Health (Brick, NJ)
    …to transform healthcare and serve as a leader of positive change. The **Care Coordinator , Care Management** is a member of the healthcare team and is responsible for ... services. **Responsibilities** A day in the life of a **Care Coordinator , Care Management** at **Hackensack Meridian** **_Health_** includes: + Assesses patients… more
    Hackensack Meridian Health (01/04/25)
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  • Care Coordinator , Care Management,…

    Hackensack Meridian Health (Hackensack, NJ)
    …to transform healthcare and serve as a leader of positive change. The Care Coordinator , Care Management is a member of the healthcare team and is responsible for ... **Responsibilities** A day in the life of a Care Coordinator , Care Management at Hackensack Meridian _Health_ includes: +...or meetings. + Identifies and refers quality issues for review to the Quality Management Program. + Participates in… more
    Hackensack Meridian Health (12/31/24)
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  • Care Coordinator (LSW/LCSW) - Full Time…

    Hackensack Meridian Health (Brick, NJ)
    …to transform healthcare and serve as a leader of positive change. The Care Coordinator , Care Management is a member of the healthcare team and is responsible for ... **Responsibilities** A day in the life of a Care Coordinator , Care Management at Hackensack Meridian _Health_ includes: 1....or meetings. 8. Identifies and refers quality issues for review to the Quality Management Program. 9. Participates in… more
    Hackensack Meridian Health (12/27/24)
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  • Sr. Field Performance Coordinator

    Sunrun (Trenton, NJ)
    …commitment to diversity, inclusion and belonging. **Overview** The Field Service Coordinator is responsible for coordinating effective execution of field service ... and develop partner or branch relationships including weekly/monthly reviews, utilization and workload management, process updates and identification and resolution… more
    Sunrun (12/07/24)
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  • GME Academic Program Coordinator

    Virtua Health (Voorhees, NJ)
    …40 Additional Locations: Job Information: Job Summary: The GME Academic Program Coordinator is responsible for assisting with the duties and processes related to ... financial reports, encompassing IRIS/Medicare cost reporting, Virtua GME funds utilization reports, and comprehensive documentation of Grants and/or Foundation… more
    Virtua Health (12/03/24)
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  • Senior Intake Coordinator

    Highmark Health (Trenton, NJ)
    …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... verifying benefit coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review , status… more
    Highmark Health (11/09/24)
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  • Critical Care Transfer Coordinator (RN)…

    Atlantic Health System (Florham Park, NJ)
    …plan, including transfer eligibility, level of care, resource prioritization & utilization , timely acceptance, and appropriate priority and mode of transport. + ... appropriate transport priority and mode, while considering appropriate resource utilization and timeliness of transfer. + Communicates transport information to… more
    Atlantic Health System (12/04/24)
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  • Precertification Nurse

    NJM Insurance (Trenton, NJ)
    …and Auto (PIP/Medpay) lines of business by performing prospective and retrospective Utilization Review of medical services/treatment requested or rendered by ... to uphold, modify, or overturn prior decisions. + Conduct Inpatient Care utilization review using NJM and evidence-based clinical guidelines to ensure… more
    NJM Insurance (11/06/24)
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  • Care Coordination Specialist

    Hackensack Meridian Health (Neptune, NJ)
    …information, inclusive of free text fields, to support the case management, utilization review process. + Retrieves information for the Physician Advisors ... prior to discharge. + In collaboration with the Care Coordinator , reviews daily admission data to verify inpatient insurance...+ Verifies admission and discharge date information. + Updates Utilization Review RN needed for payors. +… more
    Hackensack Meridian Health (10/24/24)
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  • Nurse Manager RN - Telemetry Unit - Full Time/Day…

    Penn Medicine (Plainsboro, NJ)
    …oversees medical unit, central monitoring room, and Congestive Heart Failure Coordinator . This is a registered professional nurse responsible for visioning, ... + Quality Improvement Plan + Unit budget + Resource Utilization + Human Resource Management + Master Unit Staffing...functioning according to Medical Center at Princeton standards. + Review the unit's performance in relation to established goals… more
    Penn Medicine (12/27/24)
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  • Integrated Case Management Specialist - Full Time

    Hackensack Meridian Health (Hackensack, NJ)
    …information, inclusive of free text fields, to support the case management, utilization review process. 5. Retrieves information for the Physician Advisors ... Meridian _Health_ includes: 1. In collaboration with the Care Coordinator , reviews daily admission data to verify inpatient insurance...discharge dates. 8. Enters LAD into EPIC. 9. Keeps Utilization Review RN current on updates needed… more
    Hackensack Meridian Health (01/01/25)
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  • Licensed Respiratory Therapist

    Chatham Hills Subacute Care Center (Chatham, NJ)
    …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... the administrator in development of the annual budget. Appropriate and effective utilization of staff. Managing key operations and financial levers to achieve budget… more
    Chatham Hills Subacute Care Center (12/14/24)
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  • Supervisory Accountant

    Transportation Security Administration (Egg Harbor Township, NJ)
    …Ensures the integrity of the LE/FAMS financial data, including the Coordination and review of Quarterly UDO Verification and Validation (V&V) and the role of ... the Travel Card Program in LE/FAMS, including Agency/Organization Program Coordinator responsibilities for individually billed accounts and the centrally billed… more
    Transportation Security Administration (01/08/25)
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