- Atlantic Health System (Morristown, NJ)
- …of all team members. Offerings vary based on role level (Team Member, Director , Executive ). Below is a general summary, with role-specific enhancements ... issues to Physician Advisors or Designees in compliance with department procedures with timely follow up as indicated 6....collection of avoidable days 7. Coordinates with the CM RN and/or CMA to identify and complete the process… more
- Fresenius Medical Center (Teaneck, NJ)
- …Human Resources on employee matters. + Technically proficient in the specific department and knowledge of industry practice and business principles. Works on issues ... an understanding of current business trends. Has a larger range within the department . + Responsible for supporting and driving FMS quality standards through meeting… more
- Fresenius Medical Center (Flemington, NJ)
- …Clinical Manager, you may advance your career into an Area Team Lead or Director of Operations role. **Our culture:** We believe our employees are our most important ... you may need us most, from tuition reimbursement to support your education goals, granting scholarships to family members, delivering relief when natural disasters… more
- Atlantic Health System (NJ)
- …new skills + Accepts other assignments to support agency. 10. Attends continuing education to develop proficiency in OASIS review and ICD-10 coding. Required: ... 1. Provides timely review of SOC, ROC and Recertification documentation. Utilizes...members. Offerings vary based on role level (Team Member, Director , Executive ). Below is a general summary,… more
- Atlantic Health System (Basking Ridge, NJ)
- …Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work 8AM- 4PM in the Somerset County area, including ... Program- Associates Degree 2. Current state licensure as a Registered Nurse . 3. BLS certification. Preferred: 1....members. Offerings vary based on role level (Team Member, Director , Executive ). Below is a general summary,… more
- CVS Health (Trenton, NJ)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Evolent (Trenton, NJ)
- …the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... are performed within the ** RN /LVN/LPN** scope of practice, under the Medical Director...medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate,… more
- Elevance Health (Morristown, NJ)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... time,** **with rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for conducting preauthorization, out… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- …meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training ... a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a.... Maintaining close communications within the facility with the director of nursing, nurse managers, and admissions… 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