- CVS Health (Trenton, NJ)
- …we do it all with heart, each and every day. **Position Summary** The ** Utilization Management Clinical Nurse Consultant** utilizes clinical skills to ... Arizona Time Zone. **Preferred Qualifications** : + Previous experience with utilization management . + Previous clinical experience in Emergency Department,… 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)
- …able to work an Eastern Standard Time schedule** **Must be a licensed RN** + 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
- Hackensack Meridian Health (Edison, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… 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
- 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 part-time hospice Registered Nurse to work 9 AM to 7 PM in the Morris County area, ... 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
- Evolent (Trenton, NJ)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… 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