- US Tech Solutions (Hopewell, NJ)
- …case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and ... to the continuum of care. Performs duties and types of care management as assigned by management .** **Responsibilities:** 1. Assesses patient's clinical… more
- Cognizant (Trenton, NJ)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- Hackensack Meridian Health (Edison, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
- St. Luke's University Health Network (Easton, PA)
- …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among all ... regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex discharge… more
- St. Luke's University Health Network (Quakertown, PA)
- …, including but not limited to: RN care managers, assistants, coordinators, utilization management staff, and director. . Facilitates communication among all ... regardless of a patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex discharge… more
- CVS Health (Trenton, NJ)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Atlantic Health System (Basking Ridge, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work 8AM- 4PM in the Somerset County area, including ... heavy caseload (up to 4 patients a day); time management skills are essential. However, it is important to...of care for the patient and family Ensures appropriate utilization of services + Maintains visit productivity standards +… more
- St. Luke's University Health Network (Phillipsburg, NJ)
- …, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among ... The RN Care Manager coordinates the overall progression of care, resource utilization , and discharge planning for designated patient populations across the continuum… more
- St. Luke's University Health Network (Easton, PA)
- …, including but not limited to: Social workers, assistants, coordinators, utilization management staff, and director. + Facilitates communication among ... patient's ability to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for...obtained within 3 years of hire, MSN and/or Case Management Certification preferred. TRAINING AND EXPERIENCE: Preference is for… 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
- Evolent (Trenton, NJ)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- Schedule . 5 days a week 37.5 - 40 hours per week Respiratory Nurse (RN) We are searching for a highly motivated, flexible, organized, skilled respiratory therapist ... meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions. +… more
- Fresenius Medical Center (Flemington, NJ)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… 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 skill ... set knowledge preferred * CTBS Certified or willing to obtain within two years of employment **Essential Skills, Experience, and Competencies** Understanding & Recognizing (but not limited) the following: * physical assessment findings * history & physical… more
- Hackensack Meridian Health (Edison, 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
- Elevance Health (Morristown, NJ)
- **Clinical Operations Medical Director** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Atlantic Health System (Morristown, NJ)
- …results. * Demonstrated strength in resource management and financial management . * Experience with ANCC Magnet nurse standards. Performance Expectations ... results. * Demonstrated strength in resource management and financial management . * Experience with ANCC Magnet nurse standards. Performance Expectations… more
- BAYADA Home Health Care (Morristown, NJ)
- …+ Management and mentoring of Clinical Associates and field staff + Utilization Management + Developing and mentoring staff to become strong case managers ... is currently seeking a Full-time or a Part-Time **Registered Nurse , RN,** to fill the position of **_Clinical Associate_**...+ A current New Jersey RN license. + Strong management and leadership experience. + Medicare Certified Home Care… more
- Penn Medicine (Plainsboro, NJ)
- …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. In ... the multi-disciplinary care team to effect timely, appropriate patient management .Addresses/resolves system problems impeding diagnostic or treatment progress. Proactively… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Health System is seeking a dynamic Registered Nurse to join the energetic and innovative team of healthcare professionals as a Inpatient Care Manager on the ... Care Management Team at Morristown Medical Center. This is a...member populations across the continuum of illness, ensure effective utilization and monitors health care resources, manage the interdisciplinary… more