- CVS Health (Trenton, NJ)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, ... to promote quality effectiveness of Healthcare Services and benefit utilization * Consults and lends expertise to other internal...Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must… more
- US Tech Solutions (Hopewell, NJ)
- …7. Advocates for the member/family among various sites to coordinate resource utilization and evaluation of services provided. 8. Encourages member participation and ... of care. 11. Understands fiscal accountability and its impact on the utilization of resources, proceeding to self-care outcomes. 12. Evaluates care by problem… more
- Cognizant (Trenton, NJ)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience in ... to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical… more
- Penn Medicine (Plainsboro, NJ)
- …discharge planning and communicates plan clearly to patient, family and Utilization Review Nurse , Financial Counselor and outpatient treatment providers ... + Communicate effectively the essential clinical features of each case with utilization reviewers and monitors patient attendance in scheduled program and length of… more
- Hackensack Meridian Health (Hackensack, NJ)
- **The Per Diem Advanced Practice Nurse (APN) or Physician Assistant (PA) for the Transition Utilzation Review Team utilizes a patient-centered coordinated care ... nursing program. 2. Master's or Doctorate degree from an accredited Nurse Practitioner program. 3. Maintains clinical competencies through continuing education and… more
- Hackensack Meridian Health (Edison, NJ)
- …and serve as a leader of positive change. The **Care Management, Care Coordinator, Utilization Management** is a member of the healthcare team and is responsible for ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of stay,… more
- Hackensack Meridian Health (Hackensack, NJ)
- **The post-graduate internal medicine fellowship for Nurse Practitioners is designed to provide Advanced Practice Nurses an opportunity to engage in both didactic ... the top medical centers in the nation. During the year-long fellowship, the Nurse Practitioner will rotate through a variety of patient care settings, including an… more
- CVS Health (Trenton, NJ)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in...lower levels of care. + 1+ years' experience in Utilization Review. + CCM and/or other URAC recognized accreditation… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time GIP hospice Registered Nurse to work 12PM to 730PM in the Morris, Essex, Union, ... Develops the plan of care for the patient and family Ensures appropriate utilization of services + Maintains visit productivity standards + Demonstrates knowledge of… more
- Evolent (Trenton, NJ)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
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