- Centene Corporation (Trenton, NJ)
- …findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and ... preferred. Knowledge of Medicare and Medicaid regulations preferred. Knowledge of utilization management processes preferred. **License/Certification:** + LPN -… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work 9 AM to 5 PM in the Essex County area, including ... managing a heavy caseload (4 patients a day); time management skills are essential. However, it is important to...of care for the patient and family Ensures appropriate utilization of services + Maintains visit productivity 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 ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Elevance Health (Woodbridge, NJ)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- RWJBarnabas Health (Newark, NJ)
- … Nurse (RN) Full Time Days CTICUReq #:0000204650 Category:Nursing Management / Leadership Status:Full-Time Shift:Day Facility:Newark Beth Israel Medical Center ... standards. Support of the Healthcare Environment Ensures effective, appropriate utilization of human, fiscal, and material resources by assuring appropriate… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- Schedule . 5 days a week 37.5 - 40 hours per week Respiratory Nurse (RN) We are searching for a highly motivated, flexible, organized, skilled respiratory therapist ... meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions. +… more
- RWJBarnabas Health (Somerset, NJ)
- Nurse Coordinator RNReq #:0000224588 Category:Nurses Status:Part-Time Shift:Night Facility:RWJBarnabas Health Corporate Services Department:Patient Transfer Center ... Location: 379 Campus Dr, Somerset, NJ 08873 Job Title: Nurse Coordinator RN Location: 379 Campus Drive Department Name:...as well as experience in clinical care operations, case management and/or patient throughput + Must have a working… more
- CVS Health (Moorestown, NJ)
- …high-quality, cost-effective care for our members. These strategies encompass utilization management , quality improvement, network coordination, and clinical ... upon achieving proficiency in the role. **Required Qualifications** + Active, unrestricted **Registered Nurse (RN) license in New Jersey** . + Minimum of **3 years… more
- Evolent (Trenton, NJ)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... is 11:30-8:00 eastern** **OTHER SKILLS and ABILITIES:** Strong clinical, management , communication, and organizational skills. Demonstrated leadership skills Analytic… more
- CVS Health (Trenton, NJ)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... responsible for telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the… more