- Evolent (Trenton, NJ)
- …Join a mission with a company behind it. **What You'll Be Doing:** The Evolent Appeals Nurse team offers candidates the opportunity to make a meaningful impact ... as part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to… more
- NJM Insurance (Trenton, NJ)
- …(ODG and/or MCG). + Conduct second level review of PIP Post-Service/Payment Appeals to assess prior determination and new records, including treatment, Independent ... business process improvements. Required Skills & Experience: + Actively licensed registered Nurse in New Jersey and Connecticut, Delaware, Maryland, New York or… more
- Hackensack Meridian Health (Edison, NJ)
- …care management processes, including LOS, throughput, patient flow and denials and appeals follow up. + Applies process improvement methodologies in evaluating team ... Suite platforms. **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License or NJ Licensed Social Worker or NJ Licensed Clinical… more