- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Trenton, NJ)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...**Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care… more
- US Tech Solutions (Hopewell, NJ)
- …**Additional licensing, certifications, registrations:** 1. Requires an active New Jersey Registered Nurse License. **Knowledge:** - Prefers proficiency in the ... case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and… more
- 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
- CenterWell (Trenton, NJ)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- Cognizant (Trenton, NJ)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Fresenius Medical Center (Teaneck, NJ)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Atlantic Health System (Morristown, NJ)
- …Visiting Nurse , part of Atlantic Health System, is seeking a full-time GIP hospice Registered Nurse to work 9 AM to 9 PM in the Morris, Essex, Union, ... heavy caseload (up to 4 patients a day); time management skills are essential. However, it is important to...Program- Associates Degree. 2. Current state licensure as a Registered Nurse . 3. BLS certification. Preferred: 1.… more
- CVS Health (Trenton, NJ)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… more
- Veterans Affairs, Veterans Health Administration (East Orange, NJ)
- …Required Documents below. The East Orange VA Medical Center is looking for an experienced Registered Nurse with a focus on Population Health. This nurse is ... services internal and external to the VA to facilitate management of complex patient populations and facilitate performance improvement....level degree in Nursing may have opportunity to become registered as a nurse with a state… more