- CenterWell (Trenton, NJ)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF,… more
- CenterWell (Trenton, NJ)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing… more
- Atlantic Health System (Morristown, NJ)
- …- Becker's Healthcare + 100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 - AARP + Gold-Level "Well ... safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in… more
- Atlantic Health System (Morristown, NJ)
- …- Becker's Healthcare + 100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 - AARP + Gold-Level "Well ... safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in… more
- CVS Health (Trenton, NJ)
- …models. You can have a life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social ... to enhance a member's overall wellness. * Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits. * Applies clinical… more
- Atlantic Health System (Morristown, NJ)
- …- Becker's Healthcare + 100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 - AARP + Gold-Level "Well ... safety grade - its highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its highest five-start rating in… more
- Fresenius Medical Center (Kenvil, NJ)
- …effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance ... well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual… more
- Fresenius Medical Center (Marlton, NJ)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training and in compliance ... well-being since their last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and report any unusual… more
- Humana (Trenton, NJ)
- …medical directors and leadership during Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical ... maintain medical coverage policies utilizing an evidence based medicine review process. **Location:** work at home anywhere Humana is...any field or equivalent experience + Active unrestricted Registered Nurse (RN) license + 5 years or more of… more
- Option Care Health (Morris Plains, NJ)
- …is maintained by providing direct patient care 20-40% of the time. In a Medicare Certified Home Health agency, this position may also serve as the alternate ... Director of Nursing of the Home Health Agency for Medicare certified home health agencies in the absence of...reporting nursing operational and financial data to the Regional Nurse Manager, Area Director of Nursing, and/or Director of… more