- 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
- US Tech Solutions (Branchburg, NJ)
- …on an **acute/critical care** unit, organ donation/transplant unit, in tissue/blood banking, utilization review and/or case management with critical care skill ... set knowledge preferred * CTBS Certified or willing to obtain within two years of employment **Essential Skills, Experience, and Competencies** Understanding & Recognizing (but not limited) the following: * physical assessment findings * history & physical… more
- Hackensack Meridian Health (Perth Amboy, NJ)
- …expert computer skills. + Familiar with hospital resources, community resources, and utilization management . + Excellent written and verbal communication skills. ... a leader of positive change. The **Care Coordinator, Care Management ** is a member of the healthcare team and...degree. Licenses and Certifications Required: + NJ Licensed Registered Nurse or NJ Licensed Social Worker or NJ Licensed… more
- Veterans Affairs, Veterans Health Administration (Toms River, NJ)
- …for assisting the Veterans in providing a smooth process for the management of outpatient appointments. Responsibilities The Advanced Medical Support Assistants are ... as it relates to access to care and clinic management , and will assist with the treatment given to...review the clinics appointment schedule to ensure that clinic utilization is optimized and effectively supports the needs of… more
- Elevance Health (Morristown, NJ)
- **Clinical Operations Medical Director** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Atlantic Health System (Morristown, NJ)
- …results. * Demonstrated strength in resource management and financial management . * Experience with ANCC Magnet nurse standards. Performance Expectations ... results. * Demonstrated strength in resource management and financial management . * Experience with ANCC Magnet nurse standards. Performance Expectations… more
- Datavant (Trenton, NJ)
- …function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and appeal ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for...expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in… more
- Sharecare (Trenton, NJ)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- Penn Medicine (Plainsboro, NJ)
- …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. In ... the multi-disciplinary care team to effect timely, appropriate patient management .Addresses/resolves system problems impeding diagnostic or treatment progress. Proactively… more
- AristaCare (Manchester, NJ)
- Unit Nurse Manager (RN) AristaCare is seeking a RN Unit Manager to oversee the care management of a population of patients within an assigned area, unit or ... process, assessment, planning, implementation, and evaluation under the scope of the State's Nurse Practice Act of Registered Nurse licensure. The Unit Manager -… more