• Utilization Management Nurse

    CVS Health (Trenton, NJ)
    …full-time Utilization Management (UM) Nurse Consultant. As a Utilization Management Nurse Consultant, you will utilize clinical skills to ... to promote quality effectiveness of Healthcare Services and benefit utilization . **Required Qualifications** + Registered Nurse (RN)...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
    CVS Health (10/25/25)
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  • Utilization Management Clinical…

    CVS Health (Trenton, NJ)
    …we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... Time_ ). + Previous experience with prior authorization. + Previous experience with utilization management . + Previous experience in an acute care setting. +… more
    CVS Health (10/26/25)
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  • Utilization Management Nurse

    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
    US Tech Solutions (10/24/25)
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  • Clinical Registered Nurse

    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
    Cognizant (10/07/25)
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  • Care Coordinator, Utilization

    Hackensack Meridian Health (Edison, NJ)
    …to transform healthcare and serve as a leader of positive change. The **Care Management , Care Coordinator, Utilization Management ** is a member of the ... patient's treatment. Accountable for a designated patient caseload; the Care Coordinator, Utilization Management plans effectively in order to manage length of… more
    Hackensack Meridian Health (09/25/25)
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  • Utilization Management Clinical…

    CVS Health (Trenton, NJ)
    …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
    CVS Health (10/26/25)
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  • Utilization Management Clinician-…

    CVS Health (Trenton, NJ)
    …clinical skills to coordinate, document and communicate all aspects of the utilization /benefit management program. Applies critical thinking and is knowledgeable ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years post… more
    CVS Health (10/21/25)
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  • Insurance Specialist-Mount Sinai West-…

    Mount Sinai Health System (New York, NY)
    …Excel and Word + Strong Communication skills Non-Bargaining Unit, BEZ - Utilization Management - WST, Mount Sinai West **Responsibilities** **A. ... **Job Description** **Insurance Specialist Mount Sinai West Utilization Mgmt FT Days EOW** To maintain front...EOW** To maintain front end operations of the Case Management Department by monitoring all incoming correspondence and ensuring… more
    Mount Sinai Health System (10/22/25)
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  • Disease Management Nurse - Remote

    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
    Sharecare (10/22/25)
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  • Nurse Practitioner-Cardiothoracic- Mount…

    Mount Sinai Health System (New York, NY)
    **Job Description** **Job Title : Nurse Practitioner- Cardiothoracic- Mount Sinai Hospital - Full Time - Night** A nurse practitioner (NP) as described in Title ... 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 (08/03/25)
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  • Nurse Practitioner - Klingenstein 3 NICU…

    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
    Mount Sinai Health System (09/26/25)
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  • Clinical Manager Registered Nurse - RN…

    Fresenius Medical Center (New York, NY)
    …and programs. Collaborates with the Medical Director and the Clinical Coordinator /Charge Nurse or Nurse Supervisor regarding the provision of quality patient ... closely with, providing oversight as needed to, the Clinical Coordinator/Charge RN or Nurse Supervisor acting as nurse manager, the Medical Director, and the… more
    Fresenius Medical Center (09/12/25)
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  • Clinical Nurse -Wound Care-WOCN-Mount Sinai…

    Mount Sinai Health System (New York, NY)
    **Job Description** The Nurse Clinician is a registered professional nurse who demonstrates expert clinical expertise through advanced knowledge and 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 d. Maintains clinical expertise in area… more
    Mount Sinai Health System (08/16/25)
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  • Assistant Nurse Manager Surgical Svs Float…

    Penn Medicine (Plainsboro, NJ)
    …each day. Are you living your life's work? Summary: + A professional Registered Nurse who is responsible for the direct supervision of nursing staff which is ... by: maintaining open lines ofcommunication with staff, physicians, and management ; providing resource information as requested and overseeing the delivery… more
    Penn Medicine (09/20/25)
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  • Nurse Practitioner - Cancer Center - Mount…

    Mount Sinai Health System (Long Island City, 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
    Mount Sinai Health System (09/23/25)
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  • Case Manager, Registered Nurse - Fully…

    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
    CVS Health (10/15/25)
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  • VPS Psychiatric Nurse Practitioner

    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
    City of New York (08/08/25)
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  • Nurse Manager, RN - Ambulatory Surgery…

    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
    Mount Sinai Health System (10/17/25)
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  • Nurse Manager, RN - Cardiovascular Clinic…

    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 (08/02/25)
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  • Hospice Registered Nurse - Full Time, Days,…

    Atlantic Health System (Basking Ridge, NJ)
    Atlantic 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 ... heavy caseload (up to 4 patients a day); time management skills are essential. However, it is important to...of care for the patient and family Ensures appropriate utilization of services + Maintains visit productivity standards +… more
    Atlantic Health System (10/14/25)
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