• Manager, Utilization Management Operations…

    VNS Health (Manhattan, NY)
    …CEU credits, and advancement opportunities What You Will Do + Reviews specific utilization issues or requests with Clinical Review team, focusing on problem ... Manages and evaluates staff in delivery and coordination of utilization management review services in compliance with...and current registration to practice as a registered professional nurse in New York State Required + Valid driver's… more
    VNS Health (03/14/25)
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  • VPS Psychiatric Nurse Practitioner

    City of New York (New York, NY)
    …CAS works with other programs at HRA and with other governmental and non -governmental service providers to create new programs and to integrate and refine existing ... CAS Visiting Psychiatric Services (VPS) Unit is recruiting for two (2) Psychiatric Nurse Practitioner for the roles below. Under the supervision of the Medical… more
    City of New York (02/12/25)
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  • Nurse Navigator - Transitions of Care

    Hackensack Meridian Health (Edison, NJ)
    …duties with attention to detail and in a timely manner. + Collaborates with Utilization Review Nurses. + Referrals: + Primary Care Physicians + Behavioral Health ... a leader of positive change. The **Transitions of Care Nurse Navigator** is a member of the healthcare team...Quality Metrics. + Knowledge of health care delivery system, utilization and review and case review more
    Hackensack Meridian Health (01/18/25)
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  • Medical Management Nurse

    Elevance Health (New York, NY)
    …4 years managed care experience and requires a minimum of 2 years clinical, utilization review , or case management experience; or any combination of education ... the Elevance Health major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the most complex or… more
    Elevance Health (03/13/25)
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  • Hospice Registered Nurse - Full Time, Days,…

    Atlantic Health System (Basking Ridge, NJ)
    Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work Monday - Friday from 8 AM to 4 PM in the Morris, ... of care for the patient and family Ensures appropriate utilization of services + Maintains visit productivity standards +...Morristown, New Jersey, we are one of the leading non -profit health care systems in the state, and committed… more
    Atlantic Health System (01/31/25)
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  • Clinical Program Manager, Clinical Command Center;…

    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 the 24 ... and supporting patient-centered care. **Qualifications** ? Must be a Licensed Registered Nurse , Physician Assistant or Nurse Practitioner Registered Nurse more
    Mount Sinai Health System (03/04/25)
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  • Case Manager RN - Per-Diem

    Penn Medicine (Plainsboro, NJ)
    …appropriate reimbursement, proactively identify potential denials in order to avoid non -appealable denials; Credentials: + Registered Nurse - NJ (Required) ... and accurate information to payors. The role integrates and coordinates utilization management, care facilitation and discharge planning functions. In addition, the… more
    Penn Medicine (03/04/25)
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  • Per Diem Perioperative Scheduling…

    Mount Sinai Health System (New York, NY)
    **Job Description** The (per diem) Utilization Review Specialist coordinates scheduling of all surgical/endoscopic hospital admissions, pre-admission testing and ... operating room procedures. This individual seeks the assistance of the Nurse Manager in identifying cases, which require pre admission screening or have questionable… more
    Mount Sinai Health System (02/22/25)
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