- Datavant (Trenton, NJ)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in...Excel, Outlook, experience working in a health plan medical management documentation system a plus. Minimum Education: LVN/LPN +… more
- Deloitte (Morristown, NJ)
- …skills to collaborate with clinicians, physicians, NP/PAs, ancillary departments, Quality, Case Management , Finance, Revenue Cycle, and Coders + Other ... in Clinical Informatics, Business Administration, Nursing and related health fields preferred + Case Management or Medical coding certification a plus (CRC, CCA,… more
- Travelers Insurance Company (Trenton, NJ)
- …service on assigned claims, while engaging in indemnity & expense management . Promptly manage claims by completing essential functions including contacts, ... investigation, damages development, evaluation, reserving, litigation management , negotiating and resolution. Provides consulting and training and serves as an… more
- Aveanna Healthcare (Hackensack, NJ)
- …own community. The administrative component of this job will consist of internal case management , completing patient intake and discharge to home, our start ... per year Position Details Aveanna Healthcare is hiring a Nurse Supervisor in your area! Make a difference every...Resource Groups Responsibilities of the Nursing Supervisor + Internal case management , evaluation, education and development of… more
- Humana (Trenton, NJ)
- …the start time is 10:00AM EST.** Our nurses are titled Care Managers, because our case management services are centered on the person rather than the condition. ... help us put health first** The Care Manager, Telephonic Nurse 2 employs a variety of strategies, approaches and...MCG or CMS guidelines, assessment and documentation practice + Case Management certification (CCM) + Bilingual in… more
- Hackensack Meridian Health (Wall, NJ)
- …information and plan of care is communicated in a timely manner to primary nurse and appropriate team members. Conduct case conferences throughout care and ... + Report patient care problems, along with possible solutions, to primary care nurse or appropriate social work management personnel. Communicate with supervisor… more
- Sharecare (Trenton, NJ)
- …CareFirst in a variety of areas such as integration activities, audits, and case management in collaboration with the Director. + Provide clinical/coaching ... required; Compact state preferred + Bachelor's degree preferred + 5+ years' experience in Care/ Case Management + NCQA experience preferred + Certified Case … more
- Sharecare (Trenton, NJ)
- …to Clinical Advocates ( Nurse ) for conditions that require clinical care and case management assistance + Primary duties include but are not limited to: ... during the training period will be evaluated on a case by case basis and must be...plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical,… more
- Travelers Insurance Company (Morristown, NJ)
- …process, relevant case and statutory law and expert + litigation management skills preferred. + Extensive claim and/or legal experience and technical expertise ... life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management , negotiation and resolution) including maintaining full compliance with… more
- Travelers Insurance Company (Morristown, NJ)
- …damages analysis and has a thorough understanding of the litigation process, relevant case and statutory law and expert litigation management skills preferred. + ... life cycle (customer contacts, coverage, investigation, evaluation, reserving, litigation management , negotiation and resolution) including maintaining full compliance with… more