- Cordis (Trenton, NJ)
- …or annual basis. + Focused on driving depth and increasing Cordis product utilization in existing accounts through the cultivation of new physician users and ... to all staff (including Physicians, Mid-Level providers, nurses, techs, and management ). + Complete training and obtain certification Closure products demonstrating… more
- 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
- 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
- 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
- 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
- CVS Health (Waretown, NJ)
- …high-quality, cost-effective care for our members. These strategies encompass utilization management , quality improvement, network coordination, and clinical ... upon achieving proficiency in the role. **Required Qualifications** + Active, unrestricted **Registered Nurse (RN) license in New Jersey** . + Minimum of **3 years… more
- Hackensack Meridian Health (Manahawkin, NJ)
- …expert computer skills. + Familiar with hospital resources, community resources, and utilization management . + Excellent written and verbal communication skills. ... a leader of positive change. The **Care Coordinator, Care Management ** is a member of the healthcare team and...degree. Licenses and Certifications Required: + NJ Licensed Registered Nurse or NJ Licensed Social Worker or NJ Licensed… more
- Intermountain Health (Trenton, NJ)
- …+ Care Management Certification + Demonstrated experience in case management , utilization review, or discharge planning. + Bi-Lingual/Spanish Speaking ... The RN Ambulatory Care Manager I delivers comprehensive ambulatory care management services to identified patients. Leveraging clinical expertise, this role involves… more
- Sharecare (Trenton, NJ)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- AristaCare (Manchester, NJ)
- Unit Nurse Manager (RN) AristaCare is seeking a RN Unit Manager to oversee the care management of a population of patients within an assigned area, unit or ... process, assessment, planning, implementation, and evaluation under the scope of the State's Nurse Practice Act of Registered Nurse licensure. The Unit Manager -… more
- Penn Medicine (Plainsboro, NJ)
- …discharge planning and communicates plan clearly to patient, family and Utilization Review Nurse , Financial Counselor and outpatient treatment providers ... interdisciplinary treatment team in a general hospital setting, providing case management and primary psychotherapy with inpatients and outpatients suffering from… more
- Highmark Health (Trenton, NJ)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... 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)
- …health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care, ... education, connecting members to resources, and facilitating referrals to care management programs for continued support. This position supports the development and… more
- Virtua Health (Willingboro, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... local regulatory guidelines. Job Responsibilities: Financial / Revenue Cycle Management Oversees the daily/monthly expenditures, staffing and overtime hours. Ensures… more
- Hackensack Meridian Health (Brick, NJ)
- …ED inpatient admissions and observations as specified by the facility's Utilization Management /Review Committee for documentation completeness and compliance ... with physicians, nursing staff, other patient caregivers, Health Information Management Department coding staff, and Emergency Trauma Department (ETD), to… more
- Erickson Living (Tinton Falls, NJ)
- …and dehydration. + Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement/Risk Management /Safety (PI/RM/S) ... a plus. + Minimum 3 years' experience in a healthcare leadership role (Charge Nurse , Unit Manager, etc.). + Experience with an electronic medical record (EMR) system… more
- Oracle (Trenton, NJ)
- …alignments, Critical Care workflow implementation, Multi-Disciplinary Rounding, and various nurse chart review and documentation optimizations. The ideal candidate ... sessions, and offer ongoing consultation to support user proficiency and system utilization . Monitor project outcomes, track key metrics, and report progress to… more
- Virtua Health (Evesham, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... processes and maintains required documentation and reports such as productivity/ utilization , medical records, customer surveys, audits, financial reports, staff… more
- Virtua Health (Moorestown, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... Virtua policies and procedures. Position Responsibilities Demonstrates thorough knowledge and utilization of all Nuclear Medicine and PET equipment and consistently… more
