- Hackensack Meridian Health (Hackensack, NJ)
- The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical ... Hackensack University Medical Center. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Hackensack Meridian Health (Hackensack, NJ)
- **The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
- Atlantic Health System (Summit, NJ)
- …from ABQAURP (The American Board of Quality Assurance and Utilization Review Physicians), AAPL (American Association for Physician Leadership's Physician ... in Management course), or CPUR (Certification Program in Utilization Review ), Institute for Healthcare Improvement courses, or physician advisor training… more
- Hunterdon Health Care System (Flemington, NJ)
- This is an in-person role. Position Summary The Utilization Review Specialist monitors adherence to the hospital's utilization review plan to ensure the ... an applicable health insurance plan. Primary Position Responsibilities 1. Performs utilization activities, using Milliman Care Guidelines under the guidance of the… more
- Hackensack Meridian Health (Neptune City, NJ)
- …outcomes. + Board Certification by the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) preferred. + Membership in the American ... Medical Center** is seeking a highly motivated and experienced physician to join our team as a ** Physician...with leadership skills to optimize patient care and resource utilization within our dynamic healthcare environment. As a key… more
- Evolent (Trenton, NJ)
- …Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/ Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance for ... all cardiology administrative and clinical utilization management and quality improvement functions under the auspices...UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory… more
- Highmark Health (Trenton, NJ)
- …DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the multidisciplinary team ... Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in… more
- Elevance Health (Morristown, NJ)
- …+ Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate on committees or in ... decisions to members and providers. **How you will make an impact:** + Perform physician -level case review , following initial nurse review , of Medical… more
- Evolent (Trenton, NJ)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be...Management, you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Trenton, NJ)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Oncology, you will be a key member of the utilization management team. We can offer you a meaningful...and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will… more