- Organon & Co. (Plymouth Meeting, PA)
- …include Health Care Providers such as Physicians across multiple specialties, Nurse Practitioners, Physician Assistants, Midwives, Nurses and Pharmacist in addition ... programs, Federally Qualified Health Centers, Universities, Independent Physician Associations, Management Service Organizations, Planned Parenthood and Family Planning Clinics,… more
- Humana (Trenton, NJ)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Lincoln Financial (Trenton, NJ)
- …and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred skills ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- ICW Group (Philadelphia, PA)
- …AND SKILLS** Understanding of Workers' Compensation, Workers' Compensation Managed Care processes, Utilization Review, Telephonic Nurse Case Management , and ... **ESSENTIAL DUTIES AND RESPONSIBILITIES** Provides oversight for all vended Nurse Case Management (NCM) products, including Field... management issues related to bill review, case management and utilization review. + Works closely… more
- CVS Health (Trenton, NJ)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... Abuse or Maternity/ Obstetrics experience. **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator or nurse… more
- Penn Medicine (Philadelphia, PA)
- …have direct responsibility for staffing, regulatory compliance, employee performance management , clinical education and competency, capacity utilization , and ... you living your life's work? Summary: + The role of the Integrated Clinical Nurse Manager is an integrated role within the Oncology service line/Cancer Service Line… more
- ChenMed (Philadelphia, PA)
- … management programs, clinical meetings and other meetings. The Nurse Practitioner, Specialty incumbent adheres to strict departmental goals/objectives, standards ... we need great people to join our team. The Nurse Practitioner (NP), Specialty acts as part of the...nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed… more
- CVS Health (Trenton, NJ)
- …identified. - Complete inpatient confinement calls and monitoring for discharge - Management of warm transfers form concierge and engagement hub - Provides clinical ... not limited to: Coordination with -PCP and Specialty providers, Condition Management information and education, Medication management , Community Resources and… more
- Virtua Health (Marlton, NJ)
- …over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques ... Locations: Job Information: *Current board certification as WOC (ET) nurse (CWOCN) by the Wound, Ostomy and Continence Nursing...determine the types of services to be provided. Case management nurses provide education in disease management … more
- Penn Medicine (Philadelphia, PA)
- …life's work? TheHospital of the University of Pennsylvania (HUP)is seeking an _Assistant Nurse Manager_ to join the _Labor & Delivery (Ravdin 7) team!_ These honors ... Obstetric Anesthesia and Perinatology Center of Excellence Award Summary: + Assists Nurse Manager by assuming 24-hour accountability for the operation of the… more
- Highmark Health (Trenton, NJ)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... within the first 6 months of employment. **Preferred** + Certification in utilization management or a related field + Certification in Case Management … more
- Evolent (Trenton, NJ)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company policies and… 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 ... over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques… more
- ChenMed (Philadelphia, PA)
- …clinical work experience required + A minimum of one (1) year of utilization review and/or case management , home health, hospital discharge planning experience ... through external providers and healthcare systems. The Acute Care Nurse is an important member of the Complex Care...plans. The success of this role is determined by management of patients in hospital to ensure patients receive… more
- Highmark Health (Trenton, NJ)
- …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... Documents, processes and routes requests for services to the nurse reviewer and other departments based on documentation procedures,...and management . + Route Cases Based on Established Guidelines. +… more
- Veterans Affairs, Veterans Health Administration (Hamilton, NJ)
- …for assisting the Veterans in providing a smooth process for the management of outpatient appointments. Responsibilities The Advanced Medical Support Assistants are ... as it relates to access to care and clinic management , and will assist with the treatment given to...review the clinics appointment schedule to ensure that clinic utilization is optimized and effectively supports the needs of… more
- Magellan Health Services (Newtown, PA)
- …Strong organization, time management and communication skills. Knowledge of utilization management procedures, mental health and substance abuse community ... other members of the clinical team, authorizes and reviews utilization of mental health and substance abuse services provided...Social Worker - Care MgmtCare Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care MgmtCare… more
- Penn Medicine (Philadelphia, PA)
- …hospice, community resources, transportation, and quality data collection and risk management referral. Responsibilities: + Utilization management ... candidate for this position must be a seasoned med/surg nurse with a minimum of 5 years' experience in... with a minimum of 5 years' experience in Utilization review and 3 years of experience in the… more
- University of Pennsylvania (Philadelphia, PA)
- …and ultrasound. Job Description Job Responsibilities We are seeking a skilled and dedicated nurse to join our team as an Operating Room and Imaging Nurse . ... and medical terminology to support the surgical team. + Act as a circulating nurse and/or scrub nurse during surgeries, providing valuable assistance to the… more
