- Atlantic Health System (Morristown, NJ)
- …Graduate of an accredited Nursing Program. 2. Current state licensure as a Registered Nurse . 3. BLS certification 4. BSN required Preferred: 1. MSN preferred 2. 2-5 ... 100 Accountable Care Organizations to Know - Becker's Hospital Review + Best Employers for Workers over 50 -...highest - twelve consecutive times, and the Centers for Medicare and Medicaid Services awarded us again with its… 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
- Virtua Health (Pennsauken, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... resource group and payers.Documentation* Appropriate and complete documentation of clinical review and denial management in the case management documentation system… more
- Fresenius Medical Center (South Plainfield, 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
- Humana (Trenton, NJ)
- …a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million ... to assist and facilitate new hires and remediation of medical directors performing Medicare utilization management processes and be the liaison for the Medicare … 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