- Atlantic Health System (Morristown, NJ)
- …Assists in identification and collection of avoidable days 7. Coordinates with the CM RN and/or CMA to identify and complete the process for CMS required patient ... notices. 8. Completes and documents utilization reviews, physician advisor referrals and other communications related to assigned cases in accordance with department… more
- RWJBarnabas Health (Livingston, NJ)
- Case Manager Registered Nurse ( RN ), Case Management ( per diem)Req #:0000191479 Category:Nursing Status: Per Diem Shift:Day Facility:Cooperman Barnabas ... Road, Livingston, NJ 07039 Job Summary: The Case Manager Registered Nurse will coordinate discharge planning to...on other classifications of patients as designated by the Utilization /Case Management Review Plan. Coordinates patient care,… more
- Fresenius Medical Center (Orange, NJ)
- …+ Plans, coordinates and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member ... all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail,… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Visiting Nurse , part of Atlantic Health System, is seeking a full-time hospice Registered Nurse to work Monday - Friday from 8 AM to 4 PM in the ... guidelines + Shows evidence of interdisciplinary communication + Performs HHA supervisions per standards + Ensures appropriate utilization of services + Follows… more
- Atlantic Health System (Chatham, NJ)
- …Handles patient triage, in-basket management and care coordination. Address patient requests, review open gaps of care and touch base with the physicians ... in cost management, including product evaluation, prevention of waste/damage, room utilization etc. Coordination of stock management + Demonstrate knowledge of… more
- Chatham Hills Subacute Care Center (Chatham, NJ)
- Schedule . 5 days a week 37.5 - 40 hours per week Respiratory Nurse ( RN ) We are searching for a highly motivated, flexible, organized, skilled respiratory ... meaningful contributions to the rehab team conferences, patient care conferences, utilization review meetings, family conferences, and caregiver training… more
- New York State Civil Service (Bronx, NY)
- NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P25595 Occupational ... New York City Children's Center - Bronx Campus is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency… more
- Mount Sinai Health System (New York, NY)
- …influence other services by focusing on patient processes. 9. Develops and implements Utilization Review (UR) based on internal data collection, data received ... the delivery of comprehensive front-line Case Management services, including utilization management, care facilitation and discharge planning. The Assistant Director… more
- Centene Corporation (New York, NY)
- …Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse - State Licensure and/or Compact State ... abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with...Licensure required Pay Range: $26.50 - $47.59 per hour Centene offers a comprehensive benefits package including:… more
- Centene Corporation (New York, NY)
- …preferred. + Knowledge of utilization management principles preferred. **License/Certification:** + RN - Registered Nurse - State Licensure and/or ... a New York RN license.** **Position Purpose:** Manages Prior Authorization, Concurrent Review , and/or Retrospective Review Clinical Review team to ensure… more
- Hackensack Meridian Health (North Bergen, NJ)
- …**Hackensack Meridian** **_Health_** includes: + Follows departmental workflows for utilization review activities including admission reviews, admission denials, ... as a leader of positive change. The **Care Coordinator, Utilization Management** is a member of the healthcare team...management **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
- Atlantic Health System (Florham Park, NJ)
- …a calm demeanor through all phases of process. Required: 1. Current licensure as a Registered Nurse ( RN ) required 2. Basic Life Support (BLS) required. 3. ... plan, including transfer eligibility, level of care, resource prioritization & utilization , timely acceptance, and appropriate priority and mode of transport. +… more
- Atlantic Health System (Morristown, NJ)
- Atlantic Health System is seeking a dynamic Registered Nurse to join the energetic and innovative team of healthcare professionals as a Inpatient Care Manager on ... patient/family assessment and multidisciplinary collaboration. 2. Ensures daily chart review , utilization reviews, coordination of discharge planning activities… more
- Molina Healthcare (Yonkers, NY)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Hackensack Meridian Health (Hackensack, NJ)
- …Abilities Preferred:** + Master's degree. **Licenses and Certifications Required:** + NJ Licensed Registered Nurse or NJ Licensed Social Worker or NJ Licensed ... or meetings. + Identifies and refers quality issues for review to the Quality Management Program. + Participates in...CMS documents to the patient and family/support person as per regulatory guidelines (ie., Important Message 4 to 48… more
- Molina Healthcare (Manhattan, NY)
- …* UAS experience * Experience conducting home visits Required Licensure or Certification: * Registered Nurse ( RN ) State Specific Requirements: * Must reside ... for Medicaid and Medicare. We are looking for a RN candidate with a Uniform System Assessor (USA) or...and using durable medical equipment (DME). * Experience in utilization review , concurrent review and/or… more
- Mount Sinai Health System (New York, NY)
- …**Experience Requirements** + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. ... **Job Description** ** RN /Case Manager MSH Case Management FT Days** The...a. Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Mount Sinai Health System (New York, NY)
- …Masters preferred. + Previous experience as in homecare, long term care or utilization review preferred. + Discharge Planner or Case Manager preferred. + ... **Job Description** ** RN /Case Manager Mount Sinai West FT Days 8a-4p...+ Reviews all new admissions to identify patients where utilization review , discharge planning, and/or case management… more
- Hackensack Meridian Health (Iselin, NJ)
- …+ Master's Degree Licenses and Certifications Required: + NJ State Professional Registered Nurse License. 160403 HACKENSACK MERIDIAN HEALTH (HMH) IS AN ... your future with a 401(k) match and Tuition Reimbursement. Per Diem team members are eligible to participate in...of Participation (COPs). + Oversee recruiting of clinical staff. Review staffing and develop appropriate staffing plan to accomplish… more
- Atlantic Health System (Pompton Plains, NJ)
- …patient/family assessment and multidisciplinary collaboration. 2. Ensures daily chart review , utilization reviews, coordination of discharge planning activities ... selected member populations across the continuum of illness. Ensures effective utilization and monitors health care resources. Manages the interdisciplinary team to… more