- Healthfirst (NJ)
- …Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management /case management . ... This position is 100% Remote . We are hiring for the following schedules...process + Additional duties as assigned Minimum Qualifications: + RN , LPN OR Dental Hygienist Preferred Qualifications: + Bachelors… more
- Virtua Health (Mount Holly, NJ)
- …and/or certification from the State of New Jersey as a MSW or Registered Nurse .Case Management Certification (requirement within one year of ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
- Virtua Health (Pennsauken, NJ)
- …and/or certification from the State of New Jersey as a MSW or Registered Nurse .Case Management Certification (requirement within one year of ... Social Worker or BSW with a minimum of 5 years experience in case management .Preferred: 3 years clinical nursing ( RN ) experience and 1 year UR/CM/QM experience… more
- Virtua Health (Marlton, NJ)
- …services in Burlington, Camden and Gloucester counties. The ideal candidate is a Registered Nurse with a minimum of one-year medical/surgical experience. Prior ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
- Lincoln Financial (Trenton, NJ)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at home employee residing outside...for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… more
- CenterWell (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and ... skills to make an impact** **Required Qualifications** + Licensed Registered Compact Nurse license ( RN )...volume and fast paced environment + Previous experience in utilization management + Education: BSN or Bachelor's… more
- J&J Family of Companies (New Brunswick, NJ)
- …TA and/or Immunology. + Must be familiar with Microsoft Word, Excel, PowerPoint, and utilization of computers and remote technologies. + Reside in or near New ... identified OLs and health care providers (MD, PA, NP, RN , Pharm.D., biocoordinators) and developing and managing a geographical...their skills in agility, applying the competencies of Change Management , Time Management and Innovation. The Sr.… more
- BD (Becton, Dickinson and Company) (Franklin Lakes, NJ)
- …to value dossiers, cost-effectiveness models, budget impact analyses, and real-world data utilization for BD Surgery products. + Ensure that all value communication ... support. + Manage external vendors where needed, eg RFP creation, project management , procurement processes, etc. + Provide guidance to lower-level employees and may… more
- Highmark Health (Trenton, NJ)
- …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year of ... + In-depth knowledge of the pharmacy industry, including benefit design, formulary management , and pharmacy best practices. + Proven ability to interpret and analyze… more
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