- 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 (Brick, NJ)
- …Engage in the teaching, consulting and advising of the care management and utilization review departments and hospital leadership. + Collaborate with a ... . + Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is **preferred** . + Physician… more
- Virtua Health (Pennsauken, NJ)
- …than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, ... UR Tech and AA to support UR and revenue cycle process.Position Responsibilities: Utilization Management* Utilizes Payer specific screening tools as a resource to… more
- Prime Therapeutics (Trenton, NJ)
- …cardholders, and pharmacies. + Escalates medical exception requests to nurse, pharmacist or physician on the utilization review clinical team when further ... our passion and drives every decision we make. **Job Posting Title** Initial Review Pharmacy Technician - Remote **Job Description** The Initial Review Pharmacy… more
- Hackensack Meridian Health (Manahawkin, 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
- Mount Sinai Health System (NJ)
- …with their job descriptions and the VMG Compact + Participate in the annual physician performance review process in Oncology Services + **Engage in the ... and the Mount Sinai Health System mean our doctors collaborate with the top physician leaders in medicine today. The Valley Hospital is one of the region's busiest… more
- Virtua Health (Marlton, NJ)
- …Palliative Care and Hospice Team members to assure that clinical protocols, utilization review , case management, quality assurance, and compliance Programs are ... than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies,… 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
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