- Elevance Health (Hamilton Township, NJ)
- RN Utilization Management - Case Management (Medicaid Long Term Care) JR155671 **Location** : New York or New Jersey. **Virtual:** This role enables ... face-to-face onboarding and skill development as needed. The **Medical Management Nurse ** is responsible for review of...and Experiences:** + A combination of utilization review/ utilization management and Case … more
- Mount Sinai Health System (New York, NY)
- …assure timely and efficient care to patients, the delivery of comprehensive front-line Case Management services, including utilization management , care ... degree preferred + 5 years of Case Management and 6 years as a clinical nurse...New York State + Certification in case management is preferred Non-Bargaining Unit, BEZ - Utilization… more
- CVS Health (Trenton, NJ)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (Trenton, NJ)
- …within Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers ... reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse with at least 1 year...keyboard **Preferred Qualifications** - 1+ years' Case Management experience or discharge planning, nurse navigator… more
- CVS Health (Plainfield, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management ,… more
- Hackensack Meridian Health (Old Bridge, NJ)
- …acute care setting. + Familiar with hospital resources, community resources, and/or resource/ utilization management . + Care coordination, case management ... leader of positive change. The role of **Supervisor, Care Management ** integrates and coordinates utilization management...Google Suite platforms. **Lice** **nses and Certifications Required:** + Registered Nurse ( RN ) with current… more
- CVS Health (Trenton, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... NJ Choice certification is a contingency of employment. **Preferred Qualifications** + Case management and/or discharge planning experience + LTSS experience +… more
- CVS Health (Freehold, NJ)
- …to our members. Health service strategies, policies, and programs are comprised of utilization management , quality management , network management , ... the State training modules, and field mentoring component **Preferred Qualifications** + Case management and/or discharge planning experience + Managed Care… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** RN / Case Manager MSH Case Management FT Days** The Case Manager (CM) will be responsible for all aspects of case ... or a minimum of 3-5 years? experience as a RN in an acute care setting. **Licensing and Certification...patients where utilization review, discharge planning, and/or case management will be needed using standardized… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review/Medical and Case Management services for Group Health and Workers' ... disability services for timely return to work. + Provides case management , utilization review, continued...MagnaCare policies and procedures. Essential Qualifications + Currently licensed Registered Nurse in the state of NY,… more
- Mount Sinai Health System (New York, NY)
- …admissions to identify patients where utilization review, discharge planning, and/or case management will be needed using standardized criteria to achieve ... Manager (CM) will be responsible for all aspects of case management for an assigned group of...Sinai St. Luke's and Mount Sinai West, BEZ - Utilization Management - WST, Mount Sinai West… more
- Atlantic Health System (Basking Ridge, 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 ... as necessary + Documents patient education tools used Assumes responsibility for Case Management . + Develops/implements/evaluates plan of care based on… more
- Molina Healthcare (New York, NY)
- …authorization requests for transplants; the ideal candidate will have experience either in utilization review or case management for transplants. Preference ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States...meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience**… more
- Hackensack Meridian Health (Holmdel, 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.... **Licenses and Certifications Required:** + NJ State Professional Registered Nurse License. + AHA Basic Health… more
- Baylor Scott & White Health (Trenton, NJ)
- **LOCATION:** Remote **SPECIALTY/DEPARTMENT:** Care Management : Case Management Utilization Management Appeals or grievances **SHIFT/SCHEDULE:** ... (2) two years of pertinent experience is essential. + ( RN ) Registered Nurse license and...EXPERIENCE IN ONE OR MORE OF THE FOLLOWING SPECIALITIES:** ** Case Management ** ** Utilization Management… more
- RWJBarnabas Health (New Brunswick, NJ)
- …related to patient evaluation, care, and management , including supervision of RN - nurse coordinators. Your efforts will ensure continuity of care, ... Heart Association (AHA) required + Must be a licensed Registered Nurse in the state of New...Supervise and develop a team of clinical staff, including RN - nurse coordinators, nurse … more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …certifications like Diabetes educator, Pediatric Nursing, Gerontological Nursing. * Current licensed Registered Nurse ( RN ) with state licensure; bachelor's ... About The Role Brighton Health Plan Solutions (BHPS) provides Case Management services to its clients. Cases...services to its clients. Cases are maintained by the Nurse Case manager. The Nurse … more
- FlexStaff (New York, NY)
- …contact hours of mandatory training requirements such as infection control coursework. - Case Management Certification recommended within two (2) years of the ... care. Serve the organization as a member of the management team, working alongside with all departments and employees...license and registration in New York State as a Registered Nurse required. Additional Requirements: - Be… more
- FlexStaff (New York, NY)
- …contact hours of mandatory training requirements such as infection control coursework. Case Management Certification recommended within two (2) years of the ... care. Serve the organization as a member of the management team, working alongside with all departments and employees...license and registration in New York State as a Registered Nurse required. Additional Requirements: Be legally… more
- Elevance Health (New York, NY)
- …The **LTSS Service Coordinator - RN Telehealth** is responsible for overall management of member's case within the scope of licensure; provides supervision ... and direction to non- RN clinicians participating in the member's case ...chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management , or similar role; or any… more