- CVS Health (Trenton, NJ)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in EST/CST zones… 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)
- …a licensed Registered Nurse , any compact licensure must cover New Jersey** + 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
- Centene Corporation (New York, NY)
- …**Must have an active New York State RN license.** **Inpatient Utilization Management ** **Position Purpose:** Supervises Prior Authorization, Concurrent Review, ... Review team to ensure appropriate care to members. Supervises day-to-day activities of utilization management team. + Monitors and tracks UM resources to ensure… more
- CVS Health (Trenton, NJ)
- …experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal ... clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult… more
- Hackensack Meridian Health (Brick, NJ)
- …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to...and Certifications Required** : + NJ State Professional Registered Nurse License. + AHA Basic Health Care Life Support… more
- Centene Corporation (New York, NY)
- …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members...Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Sharecare (Trenton, NJ)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title - Nurse Practitioner-Pediatric Cardiology - Mount Sinai Hospital - Full Time - Day** A nurse practitioner (NP) as described in ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Mount Sinai Health System (New York, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Veterans Affairs, Veterans Health Administration (New York, NY)
- Summary The Informaticist Registered Nurse (RN) exercises leadership in the assessment, planning, implementation and evaluation of hardware and software applications ... of the following core informatics functions to include content management , application support, health information technology system optimization, enterprise data… more
- Mount Sinai Health System (New York, NY)
- **Job Description** **Job Title: Clinical Nurse -Wound Care-WOCN-Mount Sinai Hospital-FT/Evenings 4pm-12am** The Nurse Clinician is a registered professional ... skills in an area of clinical nursing specialization. The nurse clinician is able to guide and promote the...Patient/Family education 3) D/C planning and follow-up 4) Case management 5) Research + Maintains clinical expertise in area… more
- Mount Sinai Health System (New York, NY)
- **Job Description** A nurse practitioner (NP) as described in Title VIII, Article 139 section 6910 of the New York Education Law is a RN who has earned a separate ... clinical nursing education in a distinct specialty area of practice. Nurse practitioners are independent practitioners who diagnose, treat, and prescribe for… more
- Veterans Affairs, Veterans Health Administration (New York, NY)
- …participants ineligible to apply. Responsibilities Interventional Radiology (IR) Registered Nurse (RN) is responsible for providing competent, evidence-based care to ... of licensed vocational nurses/nursing assistants, as appropriate to the setting. The nurse will assist in directing the provision of nursing education, orientation,… more
- Veterans Affairs, Veterans Health Administration (New York, NY)
- …orientation, competencies and providing quality improvement and outcomes utilization consultation. Independently provides patient-centered and recovery-oriented care ... health conditions. Facilitate warm hand-offs, telemental health care, and nurse -led psychoeducational groups; use therapeutic communication techniques, practice de-escalation… 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
- City of New York (New York, NY)
- …CAS Visiting Psychiatric Services (VPS) Unit is recruiting for two (2) Psychiatric Nurse Practitioner for the roles below. Under the supervision of the Medical ... for independent judgement within NYS licensing guidelines, the VPS Psychiatric Nurse Practitioner is responsible for performing psychiatric evaluations of clients at… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Nurse Manager is responsible for the management of nursing practice and operations on a designated unit/service. This includes, but is ... not limited to, the management of: clinical nursing practice, staff recruitment, retention, labor...records, internal and external regulatory and survey requirements. The Nurse Manager I collaborates with multiple professionals to support… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Nurse Manager I is responsible for the management of nursing practice and operations on a designated unit/service. This includes, but is ... not limited to, the management of: clinical nursing practice, staff recruitment, retention, labor...records, internal and external regulatory and survey requirements. The Nurse Manager I collaborates with multiple professionals to support… more