- Hackensack Meridian Health (Edison, 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...Master's degree. **Licenses and Certifications Required:** + NJ Licensed Registered Nurse or NJ Licensed Social Worker… 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
- Penn Medicine (Plainsboro, NJ)
- …timely and accurate information to payors. The role integrates and coordinates utilization management , care facilitation and discharge planning functions. In ... proactively identify potential denials in order to avoid non-appealable denials; **Credentials:** + Registered Nurse - NJ (Required) + Certified Case Manager +… 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
- Highmark Health (Trenton, NJ)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… 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 ... meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training sessions. +… more
- Hackensack Meridian Health (Neptune City, NJ)
- …ED inpatient admissions and observations as specified by the facility's Utilization Management /Review Committee for documentation completeness and compliance ... Medical/Surgical experience. **Licenses and Certifications Required:** + Current state Registered Nurse license. + Certified Clinical Documentation Specialist… more
- Highmark Health (Trenton, NJ)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- United Methodist Communities (Ocean City, NJ)
- …nursing experience. + Experience with RAI/MDS completion, reimbursement, and clinical resource utilization and/or case management . + 3-5 years of related ... Graduate of an accredited school of nursing, NJ licensed RN + Two years of long term care clinical...experience including RAI/MDS completion, reimbursement and resource utilization /case management preferred. + Holds a current… more
- CVS Health (Trenton, NJ)
- …+ 5-7 years of regulatory and/or clinical audit experience. + Experience in medical management , including Utilization Management (UM) and Case Management ... accreditation processes, and NCQA standards. + Licensed clinical professional ( RN preferred). + Excellent analytical, organizational, and communication skills. +… more