- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- RWJBarnabas Health (Livingston, NJ)
- Case Manager Registered Nurse - Case Management (FT/Days)Req #:0000179789 Category:Nursing Status:Full-Time Shift:Day Facility:Cooperman Barnabas Medical ... Road, Livingston, NJ 07039 Job Summary: The Case Manager Registered Nurse will coordinate discharge planning to...on other classifications of patients as designated by the Utilization /Case Management Review Plan. Coordinates… more
- RWJBarnabas Health (Livingston, NJ)
- Director ( Registered Nurse ), Case Management (Full-Time/Days)Req #:0000180556 Category:Leadership Status:Full-Time Shift:Day Facility:Cooperman Barnabas ... Department, including but not limited to clinical resource management , utilization review , discharge planning,...+ Current and valid license to practice as a Registered Nurse in the state of New… more
- NJM Insurance (Trenton, NJ)
- …years of prior experience in clinical nursing (Med-Surg or Critical Care preferred), Utilization Management Review /Hospital concurrent reviews, and/or Case ... comply with all statutory, regulatory, licensing requirements, and NJM policies/guidelines that affect utilization review and medical management work. + Stay… more
- Fresenius Medical Center (Somerville, NJ)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Zufall Health Center (Somerville, NJ)
- …living with HIV/AIDS. In the model for MCM Nurse , the role is provided by a registered nurse ( RN ) and will focus on the clinical services of primary care ... Registered Nurse Case Manager Somerville, NJ...with program funding policies. The level of medical case management needed by the individual clients is determined by… more
- Atlantic Health System (Morristown, 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 ... responsible for managing a heavy caseload (up to 4 patients a day); time management skills are essential. However, it is important to provide each patient with the… more
- Highmark Health (Trenton, NJ)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Sharecare (Trenton, NJ)
- …appropriate total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The RN is also responsible for ... and their Primary Care Provider according to the disease management program intervention guidelines. An RN is...orientation and to take the pre and posttests to review competency during orientation. Yearly competency test is required… more
- 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 ... a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a...facility's Employee Handbook and as communicated by the facility's management . . Contributing to a positive work team by… more
- Highmark Health (Trenton, NJ)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- CVS Health (Trenton, NJ)
- …personal, convenient and affordable. **Position Summary** This is a full-time remote Utilization Management Nurse Consultant opportunity. Utilization ... include weekends and holidays and evening rotations. As a Utilization Management Nurse Consultant, you...of residence + 3+ years of experience as a Registered Nurse + 1+ years of clinical… more
- RWJBarnabas Health (Hamilton, NJ)
- …of Microsoft applications ex. Word ,Excel Preferred: + Utilization review and discharge planning experience + Case Management certification Certifications ... Inpatients to determine appropriateness of continued stay, care planning, utilization management and discharge planning. Required: +...and Licenses Required: + Current license as a registered Nurse in the State of NJ… more
- BAYADA Home Health Care (Morristown, NJ)
- **BAYADA Home Health Care** is currently seeking a full-time ** Registered Nurse , RN ,** to fill the position of **_Clinical Nurse Manager_** in our office ... and mentoring of Clinical Associates and field staff + Utilization Management + Developing and mentoring staff... Clinical Manager include: + A current New Jersey RN license. + Strong management and leadership… more
- RWJBarnabas Health (New Brunswick, NJ)
- …Catheter Lab. The Director of the Cardiac Cath Lab and Physiology departments is a Registered Nurse ( RN ) with the knowledge, skill and competence in the ... Director, Cardiac Catheter Lab ( RN ) - New Brunswick, NJReq #:0000151612 Category:Nursing Manager...and appropriate coverage for operations + Directs all quality review functions and operations in the Department. This includes… more
- Penn Medicine (Plainsboro, NJ)
- …graduate level education. . **_Related Work Experience_** + Previous experience working as a Registered Nurse . + Unit Budget We believe that the best care ... room, and Congestive Heart Failure Coordinator. This is a registered professional nurse responsible for visioning, overseeing,...+ Quality Improvement Plan + Unit budget + Resource Utilization + Human Resource Management + Master… more
- Guardian Life (Trenton, NJ)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Atlantic Health System (Morristown, NJ)
- …patient/family assessment and multidisciplinary collaboration. 2. Ensures daily chart review , utilization reviews, coordination of discharge planning activities ... selected member populations across the continuum of illness. Ensures effective utilization and monitors health care resources. Manages the interdisciplinary team to… more
- CVS Health (Trenton, NJ)
- …state of New Jersey as one of the following: Licensed Clinical Social Worker (LCSW), Registered Nurse ( RN ), Clinical Nurse Specialist (CNS), Licensed ... + 4+ years demonstrated experience in managed care Utilization Management to include prior authorization, concurrent review OR demonstrated experience… more
- US Tech Solutions (Branchburg, NJ)
- … on an **acute/critical care** unit, organ donation/transplant unit, in tissue/blood banking, utilization review and/or case management with critical care ... Schedule - 7:30 am-4:00 pm M-F We need an RN that has at least 5 years' experience in...Tissue/Blood banking * Critical care skill set. The chart review is critical, and the candidate must have knowledge… more