- CVS Health (Trenton, NJ)
- …**Must be able to work an Eastern Standard Time schedule** **Must be a licensed Registered Nurse , any compact licensure must cover New Jersey** + Utilization ... **Required Qualifications** + Must have active, current and unrestricted RN licensure in New Jersey or Compact RN... License + 3+ years of clinical experience + Utilization Management is a 24/7 operation and… more
- Sharecare (Trenton, NJ)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations Manager (OM). All Sharecare… more
- CVS Health (Linden, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... for all other eligible external candidates._** **This is a remote Case Manager opportunity with** **50 to 75% field...modules, and field mentoring component. Are you a licensed registered nurse who is passionate about making… more
- CVS Health (Hoboken, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... do it all with heart, each and every day. **Position Summary** This is a Field/ Remote Case Manager opportunity with 50 to 75% field travel in Hudson County and… more
- CVS Health (Hackensack, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... for eligible external candidates who possess NJ Choice Certification_** **This is a remote Case Manager opportunity with** **50 to 75% field travel in Bergen County… more
- CVS Health (Trenton, NJ)
- …Qualifications** + Must reside in EST zone + 3+ years of experience as a Registered Nurse + 3+ years of clinical experience required + Must have active ... reside in EST time zone.** This is a full-time remote position. + Utilizes clinical experience and skills in...able to work Monday through Friday, 8:00am to 5:00pm. Utilization management is a 24/7 operation. Work… more
- Humana (Trenton, NJ)
- …+ Minimum 3 years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Exceptional attention to detail. + Demonstrated excellent time ... + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health; MED-Deeming accreditation standards… more
- Highmark Health (Trenton, NJ)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... required depending on where clinical care is being provided. **Preferred** + Certification in utilization management or a related field + Certification in Case … more
- Alight (NJ)
- …link between all parties involved in disability cases. The RN Nurse Team Manager will have team management responsibility, including coaching, guiding ... medical advisory experience in occupational health, disability, health case management , or utilization review. + Minimum of...of 2 years as a Clinical Case Manager. + Registered Nurse , Nurse Practitioner, or… more
- Sharecare (Trenton, NJ)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager....will follow company policy to transfer call to an RN or appropriate colleague when member needs are outside… more
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