- CVS Health (Trenton, NJ)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST/CST zones… more
- US Tech Solutions (Hopewell, NJ)
- …case/care management principles. - Prefers working knowledge of principles of utilization management . - Prefers basic knowledge of health care contracts and ... to the continuum of care. Performs duties and types of care management as assigned by management .** **Responsibilities:** 1. Assesses patient's clinical… more
- CVS Health (Trenton, NJ)
- …a licensed Registered Nurse , any compact licensure must cover New Jersey** + Utilization Management is a 24/7 operation and the work schedule may include ... Jersey or Compact RN License + 3+ years of clinical experience + Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and… more
- CenterWell (Trenton, NJ)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CVS Health (Trenton, NJ)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Hackensack Meridian Health (Brick, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to...and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support… more
- Sharecare (Trenton, NJ)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Veterans Affairs, Veterans Health Administration (East Orange, NJ)
- …Documents below. The East Orange VA Medical Center is looking for an experienced Registered Nurse with a focus on Population Health. This nurse is expected to ... with services internal and external to the VA to facilitate management of complex patient populations and facilitate performance improvement. Improve the… more
- Hackensack Meridian Health (Hackensack, NJ)
- …and families. 12. Evaluates patient/family transition of care planning for resource utilization , cost, quality, and promotion of self- management for chronic ... **The post-graduate internal medicine fellowship for Nurse Practitioners is designed to provide Advanced Practice...8. Displays support of the institutional pillars through systems management , change management , and scholarly practices. 9.… more
- Veterans Affairs, Veterans Health Administration (East Orange, NJ)
- …knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care ... on set guidelines. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for… more